The Metabolic Syndrome, Circulating Oxidized LDL, and Risk of Myocardial Infarction in Well-Functioning Elderly People in the Health, Aging, and Body Composition Cohort

  1. Paul Holvoet1,
  2. Stephen B. Kritchevsky2,
  3. Russell P. Tracy34,
  4. Ann Mertens1,
  5. Susan M. Rubin5,
  6. Javed Butler6,
  7. Bret Goodpaster7 and
  8. Tamara B. Harris8
  1. 1Center for Experimental Surgery and Anesthesiology, Catholic University, Leuven, Belgium
  2. 2J. Paul Sticht Center on Aging, Wake Forest University Health Sciences, Winston-Salem, North Carolina
  3. 3Department of Pathology, University of Vermont, Burlington, Vermont
  4. 4Department of Biochemistry, University of Vermont, Burlington, Vermont
  5. 5Prevention Sciences Group, University of California, San Francisco, California
  6. 6Vanderbilt University, Nashville, Tennessee
  7. 7Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
  8. 8Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, Maryland
  1. Address correspondence and reprint requests to Paul Holvoet, PhD, Center for Experimental Surgery and Anesthesiology, Katholieke Universiteit Leuven, Herestraat 49, B-3000 Leuven, Belgium. E-mail: paul.holvoet{at}


The object of this study was to establish the association between the metabolic syndrome and oxidized LDL (oxLDL) and to determine the risk for coronary heart disease (CHD) in relation to the metabolic syndrome and levels of oxLDL. OxLDL was measured in plasma from 3,033 elderly participants in the Health, Aging, and Body Composition study. The metabolic syndrome was defined according to criteria established in the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. We observed that the metabolic syndrome was associated with higher levels of oxLDL due to a higher fraction of oxLDL, not to higher levels of LDL cholesterol. Individuals with the metabolic syndrome had twice the odds of having high oxLDL (>1.90 mg/dl) compared with those not having the metabolic syndrome, after adjusting for age, sex, ethnicity, smoking status, and LDL cholesterol. Among those participants who had the metabolic syndrome at study entry, incidence rates of future CHD events were 1.6-fold higher, after adjusting for age, sex, ethnicity, and smoking status. OxLDL was not an independent predictor of total CHD risk. However, those with high oxLDL showed a greater disposition to myocardial infarction (relative risk 2.25, 95% confidence interval 1.22–4.15). We concluded that the metabolic syndrome, a risk factor for CHD, is associated with higher levels of circulating oxLDL that are associated with a greater disposition to atherothrombotic coronary disease.


    • Accepted January 9, 2004.
    • Received June 23, 2003.
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