Introduction
Atherosclerosis is a continuing inflammatory state of the vessels [1]. The progression of atherosclerosis leads to myocardial infarction and sudden death [2]. It is believed that atherosclerosis is an inflammatory condition that is largely responsible for cardiovascular disease (CVD) mortality [3, 4]. Endothelial dysfunction contributes to the pathogenesis of vascular disease and plays an important role in CVD as well [5, 6]. Endothelial dysfunction is characterized by impaired activity of endothelial derived relaxant factors and increased activity of vasoconstrictor factors. However, cell adhesion molecules (CAM) including E-selectin, intercellular adhesion molecule-1 (sICAM-1) and vascular cell adhesion molecule-1 (sVCAM-1) accelerate atherosclerosis [4, 7-9].
Adhesion molecules are normally expressed by the endothelium. They also play a role in leukocyte rolling, firm adhesion, and transmigration. Furthermore, they are associated with a variety of pathophysiological processes and inflammatory disorders. Atherosclerotic lesions and fatty streaks increase the expression of sICAM-1, sVCAM-1, and P- and E-selectin on the human endothelial cells [10, 11]. E-selectin plays an important role in acute inflammation [12-14]. Moreover, sICAM-1 and sVCAM-1 are involved in chronic inflammation [15, 16]. Leukocyte adhesion is an important component of some vascular diseases and atherogenesis. Leukocyte recruitment occurs in a multistep process and selectin, which is expressed on the activated endothelial cells, is involved in the initial rolling process of leukocytes [12, 17]. The leukocyte surface has sites for selectin ligand [18]. β1 and β2 integrin are expressed on leukocytes and act as binding sites for sVCAM-1 or sICAM-1. Furthermore, selectin plays a role in the initial rolling process of leukocytes whereas sICAM-1 and sVCAM-1 mediate leukocyte arresting and firm adhesion [12, 18-20].
Dietary inflammatory potential (DIP) is a new dietary index designed to evaluate the individual’s diets. DIP is a tool to assess the potential inflammatory and anti-inflammatory properties of a diet based on food elements. In this index, values of +1, 0, and -1 indicate pro-inflammation, indifferent and anti-inflammation reactions, respectively [21]. Actually, DIP is a resource to assess pro-inflammatory effects of food ingredients based on anti-inflammatory functions [21, 22]. DIP has been linked to a variety of systemic biomarkers such as interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP) and several metabolic diseases such as CVD, cancers, and diabetes. Many studies have found that DIP is associated with the risk of metabolic syndrome and cardiovascular diseases [23-28].
Many studies have reported a positive association between DIP and CVDs [29, 30]. Due to the increase in the global risk of CVDs and related diseases in the world, it is important to find healthy dietary patterns with low inflammatory scores to tackle inflammation and CVDs. The purpose of this study was to determine the association between DIP and endothelial markers such as sICAM, sVCAM, and E-selectin in female nurses working in Isfahan hospitals.