Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Metabolic biomarkers and long-term blood pressure variability in military young male adults
Yu-Kai Lin, Pang-Yen Liu, Chia-Hao Fan, Kun-Zhe Tsai, Yen-Po Lin, Ju-Mi Lee, Jiunn-Tay Lee, Gen-Min Lin
Yu-Kai Lin, Chia-Hao Fan, Kun-Zhe Tsai, Gen-Min Lin, Department of Medicine, Hualien Armed Forces General Hospital, Hualien 970, Taiwan
Yu-Kai Lin, Jiunn-Tay Lee, Departments of Neurology, Tri-Service General Hospital, and Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 114, Taiwan
Pang-Yen Liu, Gen-Min Lin, Department of Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei 114, Taiwan
Yen-Po Lin, Department of Critical Care Medicine, Taipei Tzu-Chi General Hospital, New Taipei City 231, Taiwan
Ju-Mi Lee, Department of Preventive Medicine, Eulji College of Medicine, Daejeon 34824, South Korea
Gen-Min Lin, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
Author contributions: Lin GM contributed to conception and design of the study, and Lee JT acquired and interpreted the data; Tsai KZ analyzed the data; Fan CH, Lin YP, and Lee JM collected and reviewed the data; Lin YK wrote the article; Liu PY made critical revisions related to important intellectual content of the article; and all authors provided approval of the final version of the article to be published.
Supported by Hualien Armed Forces General Hospital, No. 805-C109-07.
Institutional review board statement: This prospective study was approved by the Institutional Review Board of the Mennonite Christian Hospital (No. 16-05-008) in the Hualien City of Taiwan.
Informed consent statement: The written informed consent was obtained from all participants.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: As the study materials were obtained from the military in Taiwan, the data were confidential and not allowed to be opened in public. If there are any needs for clarification, the readers can contact Colonel Dr. Gen-Min Lin, the corresponding author for sharing the data.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Gen-Min Lin, MD, MPhil, PhD, Assistant Professor, Chief Doctor, Department of Medicine, Hualien Armed Forces General Hospital, No. 100, Jinfeng St, Hualien 970, Taiwan.
farmer507@yahoo.com.tw
Received: February 25, 2020
Peer-review started: February 25, 2020
First decision: April 29, 2020
Revised: May 13, 2020
Accepted: May 21, 2020
Article in press: May 21, 2020
Published online: June 6, 2020
Processing time: 103 Days and 18.8 Hours
BACKGROUND
Metabolic syndrome is a cluster of cardiovascular risk factors, including central obesity, high blood pressure, elevated plasma glucose, reduced high-density lipoprotein and elevated triglyceride levels.
AIM
To investigate the relationship between metabolic biomarkers and long-term blood pressure variability (BPV) in young males.
METHODS
A cohort of 1112 healthy military males aged 18-40 years from the cardiorespiratory fitness and hospitalization events in armed forces study in eastern Taiwan was prospectively included. The following metabolic biomarkers were used: Waist circumference, serum uric acid (SUA), triglycerides, high density lipoprotein, triglycerides, and fasting glycose. BPV was assessed by average real variability (ARV) and standard deviation (SD) across 4 clinic visits during the study period (2012-14, 2014-15, 2015-16, and 2016-18). Multivariable linear regression analysis was used to determine the association after adjusting for age, body mass index, systolic and diastolic blood pressure (SBP and DBP), lipid profiles, physical activity, alcohol intake and tobacco smoking status.
RESULTS
In the unadjusted model, waist circumference was significantly and positively correlated with ARVDBP and SDDBP [β (standard errors) = 0.16 (0.049) and 0.22 (0.065), respectively], as was SUA [β = 0.022 (0.009) and 0.038 (0.012), respectively]. High-density lipoprotein was negatively correlated with ARVSBP [β = −0.13 (0.063)]. There were no associations with the other metabolic biomarkers. In contrast, only SUA was significantly correlated with SDSBP and SDDBP [β = 0.019 (0.011) and 0.027 (0.010), respectively] in the adjusted model.
CONCLUSION
Our findings showed that of traditional metabolic biomarkers, SUA had the strongest positive correlation with long-term systolic and diastolic BPV in young male adults, and the clinical relevance needs further investigation.
Core tip: This study examined the relationship between metabolic biomarkers and long-term blood pressure variability (BPV) in a military population of 1112 young males across 4 visits during a 7-year period. We found that serum uric acid and waist circumference were positively correlated with long-term BPV, whereas high-density lipoprotein was inversely correlated with long-term BPV in the unadjusted model. Only serum uric acid was positively correlated with long-term BPV in the fully adjusted model. Serum uric acid, which may reflect arterial stiffness, is likely one of the strongest metabolic biomarkers for long-term BPV and related cardiovascular risk in young male adults.
