Abstract
Psychological stress is considered to be a potential contributor in the development of arterial stiffness. However, an independent association between arterial stiffness and biological markers of stress has not yet been established. We examined the independent association between salivary alpha-amylase (sAA) activity and arterial stiffness, not mediated by cardiometabolic disease associated with arterial stiffness, in a sample of healthy Japanese men and women. Participants (992 in total, 296 men and 696 women aged 30–79 years) had neither previous cardiovascular events or stroke, nor coexisting hypertension, diabetes, or dyslipidemia. Arterial stiffness was measured by the cardio-ankle vascular index (CAVI), and increased CAVI was defined as a CAVI value of 9 or higher. A saliva sample was collected in the morning and sAA was measured with a commercial assay kit. Higher sAA activity was positively associated with greater arterial stiffness particularly among women (β = 0.070; 95% CI = 0.014–0.126; p = 0.01), and not across all participants (β = 0.042; 95% CI = −0.005–0.089; p = 0.08) and in men (β = −0.005; 95% CI = −0.097–0.087; p = 0.91). The association was strongest in the group of women aged 60 years and older (β = 0.121; 95% CI = 0.018–0.224; p = 0.02). Although the association between sAA and increased CAVI (CAVI ≥ 9) was not significant in all and sex subgroups, odds ratios (OR) for CAVI ≥ 7 were significantly high in all participants (OR = 1.25; 95% CI = 1.03–1.53) and women (OR = 1.43; 95% CI = 1.12–1.82). Elevation of sAA was associated with an increase in arterial stiffness, particularly for women aged 60 years or older.
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Acknowledgements
The authors thank all participants and staff members of the Toon Health Study for their painstaking efforts to conduct the baseline survey and follow-up.
Funding
This study was supported by JSPS KAKENHI Grant Numbers JP16K09072, JP17KK0175, JP18H03056, JP18K10087, and JP17K00881.
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T. Tajima, KT, AI, and T. Tanigawa had the original idea and developed the study design. T. Tanigawa, IS, KM, TK, and KT recruited study participants and collected data. T. Tajima performed the statistical analyses. T. Tajima wrote the first draft of the manuscript and all authors contributed to the critical revision of the manuscript. All authors read and approved the final manuscript.
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This study was approved by the ethics committees of Juntendo University (Reference number: 2014003) and Ehime University (Reference number: 20–2).
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Appendices
Appendix 1 Association of salivary α-amylase (not log-transformed value) with CAVI (continuous values)
Appendix 2 Scatter plot of sAA activity and CAVI value for sex and age subgroups
(A) Comparison between sAA (not log-transformed value) and natural log transformed sAA for all participants
(B) Sex and age subgroup using sAA activity (not log-transformed value)
(C) Sex and age subgroup using natural log-transformed sAA activity
Appendix 3 ROC analysis on various CAVI cut-off values
Appendix 4 Odds ratios (95% CI) of various CAVI cut-off values associated with 1-SD increment of natural log-transformed sAA
Total (n = 992) | Male (n = 296) | Female (n = 696) | |||||||
---|---|---|---|---|---|---|---|---|---|
Case, n | Case, % | Odds ratio (95% CI) | Case, n | Case, % | Odds ratio (95% CI) | Case, n | Case, % | Odds ratio (95% CI) | |
CAVI ≥ 6 | 971 | 97.9 | 1.31 (0.77–2.24) | 294 | 99.3 | – | 677 | 97.3 | 1.79 (0.98–3.30) |
CAVI ≥ 7 | 787 | 79.3 | 1.25 (1.03–1.53) | 254 | 85.8 | 0.90 (0.59–1.37) | 533 | 76.6 | 1.43 (1.12–1.82) |
CAVI ≥ 8 | 416 | 41.9 | 1.05 (0.88–1.25) | 154 | 52.0 | 1.02 (0.73–1.43) | 262 | 37.6 | 1.13 (0.91–1.40) |
CAVI ≥ 9 | 152 | 15.3 | 1.24 (1.00–1.53) | 68 | 23.0 | 1.20 (0.86–1.66) | 84 | 12.1 | 1.30 (0.97–1.76) |
CAVI ≥ 10 | 29 | 2.9 | 1.24 (0.82–1.87) | 16 | 5.4 | 0.94 (0.52–1.71) | 13 | 1.9 | 1.53 (0.84–2.78) |
CAVI ≥ 11 | 4 | 0.4 | 2.50 (0.40–15.51) | 1 | 0.3 | – | 3 | 0.4 | – |
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Tajima, T., Ikeda, A., Steptoe, A. et al. The independent association between salivary alpha-amylase activity and arterial stiffness in Japanese men and women: the Toon Health Study. Hypertens Res 45, 1249–1262 (2022). https://doi.org/10.1038/s41440-022-00963-8
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DOI: https://doi.org/10.1038/s41440-022-00963-8
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