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The independent association between salivary alpha-amylase activity and arterial stiffness in Japanese men and women: the Toon Health Study

Hypertension Research volume 45, pages 1249–1262 (2022)Cite this article

A Comment to this article was published on 16 August 2022

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.

Author information

Authors and Affiliations

  1. Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan

    Tomokazu Tajima, Ai Ikeda, Kaho Takahashi, Kiyohide Tomooka & Takeshi Tanigawa

  2. Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan

    Ai Ikeda

  3. Department of Epidemiology and Public Health, Faculty of Population Health Sciences, University College London, London, UK

    Andrew Steptoe

  4. Laboratory of Community Health and Nutrition, Special Course of Food and Health Science, Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama, Japan

    Koutatsu Maruyama

  5. Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Yufu, Japan

    Isao Saito

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  1. Tomokazu Tajima
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Contributions

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.

Corresponding author

Correspondence to Takeshi Tanigawa.

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The authors declare no competing interests.

Ethical approval

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)

Table 5
Full size table

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

–

  1. adjusted by age, sex, education attainment level, marital status, employment status, BMI, smoking status, alcohol intake, physical activity, sleep, hypertension, LDL cholesterol, HDL cholesterol, triglyceride, blood glucose, and menopause status (female only). Missing data were addressed with specific dummy variables in the multivariate analyses

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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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