Original Article

Ann Lab Med 2016; 36(6): 542-549

Published online November 1, 2016

Copyright © Korean Society for Laboratory Medicine.

Soluble ST2 Levels and Left Ventricular Structure and Function in Patients With Metabolic Syndrome

Vera Celic, Ph.D.1,2, Anka Majstorovic, M.D.2, Biljana Pencic-Popovic, Ph.D.1,2, Aleksandra Sljivic, M.D.2, Natalia Lopez-Andres, Ph.D.3, Ignacio Roy, M.D.4, Elena Escribano, M.D.4, Maite Beunza, M.D.4, Amaia Melero, M.D.3, Federico Floridi, M.D.5, Laura Magrini, M.D.5, Rossella Marino, M.D.5, Gerardo Salerno, Ph.D.5, Patrizia Cardelli, Ph.D.5, and Salvatore Di Somma, Ph.D.5

Faculty of Medicine1, University of Belgrade, Belgrade, Serbia; University Hospital Centre “Dr DragisaMisovic-Dedinje’’2, Belgrade, Serbia; Miguel Servet Foundation-Navarrabiomed3, Pamplona, Spain; Complejo Hospitalario de Navarra4, Pamplona, Spain; School of Medicine and Psychology5, La Sapienza University, Sant’Andrea Hospital, Rome, Italy

Correspondence to: Salvatore Di Somma
University La Sapienza Rome, Sant’Andrea Hospital, Via di Grottarossa 1035/1039 00189 Rome, Italy
Tel: +3906-33775581 Fax: +3906-33775890 E-mail:

Received: February 28, 2016; Revised: May 14, 2016; Accepted: July 27, 2016


Background: A biomarker that is of great interest in relation to adverse cardiovascular events is soluble ST2 (sST2), a member of the interleukin family. Considering that metabolic syndrome (MetS) is accompanied by a proinflammatory state, we aimed to assess the relationship between sST2 and left ventricular (LV) structure and function in patients with MetS. 
Methods: A multicentric, cross-sectional study was conducted on180 MetS subjects with normal LV ejection fraction as determined by echocardiography. LV hypertrophy (LVH) was defined as an LV mass index greater than the gender-specific upper limit of normal as determined by echocardiography. LV diastolic dysfunction (DD) was assessed by pulse-wave and tissue Doppler imaging. sST2 was measured by using a quantitative monoclonal ELISA assay. 
Results: LV mass index (β=0.337, P<0 .001, linear regression) was independently associated with sST2 concentrations. Increased sST2 was associated with an increased likelihood of LVH [Exp (B)=2.20, P=0.048, logistic regression] and increased systolic blood pressure [Exp (B)=1.02, P=0.05, logistic regression]. Comparing mean sST2 concentrations (adjusted for age, body mass index, gender) between different LV remodeling patterns, we found the greatest sST2 level in the group with concentric hypertrophy. There were no differences in sST2 concentration between groups with and without LV DD. 
Conclusions: Increased sST2 concentration in patients with MetS was associated with a greater likelihood of exhibiting LVH. Our results suggest that inflammation could be one of the principal triggering mechanisms for LV remodeling in MetS.

Keywords: Soluble ST2, Metabolic syndrome, Echocardiography, Left ventricular hypertrophy