Gender differences in the association of syndecan-4 with myocardial infarction: The population-based Tromso Study

Journal article


Solbu, Marit D., Kolset, Svein O., Jenssen, Trond G., Wilsgaard, Tom, Løchen, Maja-Lisa, Mathiesen, Ellisiv B., Melsom, Toralf, Eriksen, Bjørn O. and Reine, Trine M.. (2018). Gender differences in the association of syndecan-4 with myocardial infarction: The population-based Tromso Study. Atherosclerosis. 278, pp. 166 - 173. https://doi.org/10.1016/j.atherosclerosis.2018.08.005
AuthorsSolbu, Marit D., Kolset, Svein O., Jenssen, Trond G., Wilsgaard, Tom, Løchen, Maja-Lisa, Mathiesen, Ellisiv B., Melsom, Toralf, Eriksen, Bjørn O. and Reine, Trine M.
Abstract

Background and aims: Cardiovascular disease is a common cause of morbidity and mortality, with gender differences in pathophysiology. The endothelial glycocalyx maintains vascular integrity, and glycocalyx shedding reflects endothelial dysfunction and early atherosclerosis. Syndecan-1 and -4 are components of the glycocalyx, and increased serum levels indicate glycocalyx damage. We hypothesised that increased serum syndecan-1 and -4 were independently associated with myocardial infarction (MI), ischaemic stroke and all-cause mortality in men and women from a general population. Methods: Using a case-cohort design, we included 1495 participants from the Tromsø Study 2001-02. Syndecan-1 and -4 were measured in serum. Baseline variables also included age, gender, cardiovascular risk factors and urinary albumin-creatinine ratio (ACR). Hazard ratios were assessed using multivariable Cox regression models. Results: Between baseline in 2001-02 and December 2007 fatal or non-fatal MI was experienced by 328 and ischaemic stroke by 191 subjects, and 423 participants died. Syndecan-4 was independently associated with MI (hazard ratio per 10 ng/mL increase 1.32; 95% confidence interval 1.06–1.63), but not ischaemic stroke and mortality, and the associations were unchanged by adjustment for urinary ACR. Interaction between syndecan-4 and sex was borderline significant, and in gender-specific analysis, syndecan-4 was associated with MI in women only. Syndecan-1 was not associated with any endpoint. Conclusions: Syndecan-4 was associated with incident MI, and the association was stronger in women than in men. This suggests a link between endothelial glycocalyx shedding and coronary heart disease in women. Use of syndecan-4 as a risk marker in clinical setting needs further investigation.

Keywordsglycocalyx; syndecans; cardiovascular; gender differences; epidemiology; general population
Year2018
JournalAtherosclerosis
Journal citation278, pp. 166 - 173
PublisherElsevier Ireland Ltd.
ISSN0021-9150
Digital Object Identifier (DOI)https://doi.org/10.1016/j.atherosclerosis.2018.08.005
Scopus EID2-s2.0-85054087264
Page range166 - 173
Research GroupMary MacKillop Institute for Health Research
Publisher's version
File Access Level
Controlled
Place of publicationIreland
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