Background: Endothelial dysfunction, synonymous with reduced biological activity of nitric oxide, is related to all cardiovascular risk factors. Association between metabolic syndrome and nitric oxide metabolites (nitrite + nitrate = NO(x)) has been previously shown in cross-sectional studies. The aim of this study was to determine the ability of serum NO(x) levels in predicting the incidence of metabolic syndrome in a population-based study.
Methods: Serum NO(x) levels measured in 2098 adult subjects, participants of Tehran Lipid and Glucose Study, without metabolic syndrome at baseline. After 3.3 years follow-up, logistic regression analysis was used to calculate the odds ratio (OR) and 95% confidence interval for developing metabolic syndrome, with serum NO(x) quartiles as independent variables.
Results: Incident metabolic syndrome was diagnosed in 23.0% of men and 16.3% of women after 3.3 years. Age-adjusted risk for developing metabolic syndrome in women who had higher NO(x) values (above 75th percentile vs. lower 75th percentile) at baseline, was significantly higher [OR: 1.59 (1.11-2.27), p = 0.011]; OR remained significant after multivariable-adjustment including adjustment for components of metabolic syndrome [OR: 1.75 (1.19-2.59), p = 0.005]. Serum NO(x) could not predict the incidence of metabolic syndrome in men.
Conclusions: High serum NO(x) level is an independent predictor of incident metabolic syndrome in women, but not in men, a finding which presents serum NO(x) level as a potential biomarker for assessing cardiometabolic disturbances.