Miller, Michelle A., Dr., McTernan, Philip G., Harte, Alison L., Silva, Nancy F. da, Strazzullo, Pasquale, Alberti, K. George M.M., Kumar, Sudhesh and Cappuccio, Francesco P.. (2009) Ethnic and sex differences in circulating endotoxin levels : a novel marker of atherosclerotic and cardiovascular risk in a British multi-ethnic population. Atherosclerosis, Vol.203 (No.2). pp. 494-502. ISSN 0021-9150

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Abstract

Background Circulating endotoxin levels are associated with atherosclerosis. Moreover, ethnic differences in pro-inflammatory markers may be associated with ethnic differences in atherosclerotic and cardiovascular (CVD) and coronary heart disease (CHD) risk. Objective and methods To investigate ethnic differences in circulating plasma endotoxin levels, its soluble receptor (sCD14), and high-sensitivity CRP (hs-CRP). 192 individuals, aged 40–59 years (61 white (30 women), 68 of African origin (33 women) and 63 South Asians (33 women)), free from coronary heart disease (CHD), stroke, CVD and diabetes were randomly selected from the UK ‘Wandsworth Heart and Stroke Study’. Results Age-adjusted endotoxin levels were lower in women than in men (p = 0.002) and were highest in South Asians (13.3 EU/mL [95% CI 12.0–14.7]) and lowest in individuals of African origin (10.1 EU/mL [9.1–11.1]) than in whites (p for linear trend <0.001). Endotoxin levels were positively associated with waist, waist–hip ratio, total cholesterol, serum triglycerides and serum insulin levels and negatively associated with serum HDL-cholesterol. Serum hs-CRP and plasma sCD14 varied by ethnic group (p < 0.001) but was not associated with endotoxin. Conclusions This study is the first to indicate a graded increase in endotoxin levels from black Africans to whites to South Asians, which is consistent with the ethnic difference in CHD risk. Whilst these findings support the concept that the innate immune system (IIS) may contribute significantly to the metabolic component underlying the development of CVD and CHD risk, further studies are required to see whether endotoxin levels are causally related to the development of CHD.

Item Type:	Journal Article
Divisions:	Faculty of Medicine > Warwick Medical School > Metabolic and Vascular Health Faculty of Medicine > Warwick Medical School
Journal or Publication Title:	Atherosclerosis
Publisher:	Elsevier Ireland Ltd.
ISSN:	0021-9150
Date:	April 2009
Volume:	Vol.203
Number:	No.2
Page Range:	pp. 494-502
Identification Number:	10.1016/j.atherosclerosis.2008.06.018
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
URI:	http://wrap.warwick.ac.uk/id/eprint/44002

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