In the Coronary Artery Risk Development In young Adults (CARDIA) longitudinal study, Holvoet et al. sought to examine the relationship of oxidized LDL (oxLDL) to incident metabolic syndrome in 1,889 participants aged between 18 and 30 years at baseline who were followed for 20 years. Plasma levels of oxLDL were measured by ELISA at year 15. After adjusting for potential confounders, metabolic syndrome incidence at year 20 in participants in the top quintile of year 15-oxLDL levels was 3.5 (95% CI, 1.9-6.6, p<0.001). Metabolic syndrome incidence at year 20 in participants in the top quintile of year 15-LDL cholesterol levels was 0.9 (95% CI, 0.5-1.5, p=0.55). The incidence of each component of the metabolic syndrome was also measured. Participants in the top quintile of year 15-oxLDL levels were at increased risk of having high fasting glucose [OR=2.4 (95% CI, 1.5-3.8, p=0.002)], abdominal obesity [OR=2.1 (95% CI, 1.2-3.6, p=0.004)], and high triglyceride levels [OR=2.1 (95% CI, 1.1-4.0, p=0.008)], but no association was found for HDL cholesterol levels or blood pressure. Finally, no relationship was found for quintiles of LDL cholesterol and incidence of specific components of the metabolic syndrome. The authors suggested that although the results could not establish the actual role of oxLDL in the pathophysiology of the metabolic syndrome, the association of oxLDL with the metabolic syndrome suggests it has a causal role.
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