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.