Endothelial dysfunction markers in low cardiovascular risk individuals: Comparison of males and females

Background: Cardiovascular diseases (CVD) account for approximately 50% of the total deaths in Turkey. Most of them are related with atherosclerotic coronary heart disease. Predictive value of endothelial dysfunction markers related with the earliest stage of atherosclerosis has been getting more attention. We hypothesized that differences in endothelial dysfunction biochemical markers among genders would aid to capture proatherogenic activity that was not diagnosed by conventional risk assessment scoring systems. Methods: We assessed the endothelial dysfuntion markers in 92 Turkish adults who were in the "low CV risk group" according to ESC (European Society of Cardiology)-Score Risk Charts. We compared the males and females. Results: We observed higher endothelial dysfunction rates in males, with higher median and mean levels of e-NOS, ox-LDL before and after adjustment for HDL lowness and obesity (P = 0 .0 1 8, P = 0.036 for NOS; P = 0 .000 , P= 0.004 for ox-LDL, respectively). Men had higher hsCRP levels than females before adjustment (P = 0.021). Decreased e-NOS levels were related with FMD for females before adjustment for confounders (P = 0 .0 28). We also found significant correlation between e-NOS and ox-LDL levels both before (r= 0.360, P< 0.001) and after adjustment (r= 0.366, P< 0.01) for confounders which pointed out the nitrosative stress. In multivariate regression analyses, after adjusting for other endothelial dysfunction markers which were not included in the ESC-risk scoring system, decreased e-NOS levels were independently asssociated with impaired flow mediated dilatation for females (odds ratio 0.3; P= 0.038). Conclusions: Our results underline the importance of gender in evaluating endothelial dysfunction biochemical markers to assess cardiovascular risk for low CV risk indivuals.