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      Obesity, Serum Resistin and Leptin Levels Linked to Coronary Artery Disease

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          Abstract

          Background

          Clinical studies have demonstrated that adipocytokines play an important role in developing atherosclerotic cardiovascular diseases.

          Objective

          The aim of study was to evaluate the relationship between serum resistin and leptin levels with obesity and coronary artery disease (CAD).

          Methods

          In a cross-sectional study, we assessed the levels of serum resistin and leptin, C-reactive protein (CRP), lipid profile and cardiac enzyme tests (AST, CPK, LDH, CK-MB) in 40 CAD patients compared to 40 healthy controls. Anthropometric measurements including weight and height for calculating of body mass index (BMI), and waist circumference (WC) were performed for evaluation of obesity.

          Results

          CAD patients had increased levels of leptin and CRP, (p < 0.001), cholesterol (p < 0.05), triglyceride (p < 0.01), and WC (p < 0.05) compared to healthy controls. There was no statistical difference between CAD and control subjects for resistin (p = 0.058). In a multiple regression analysis, only an association between serum leptin with BMI (β = 0.480, p < 0.05) and WC (β = 1.386, p < 0.05) was found.

          Conclusions

          The findings suggest that leptin is a better marker of fat mass value than resistin and may be considered an independent risk factor for cardiac disorders that is largely dependent on obesity. However, further prospective studies are needed to confirm these results.

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          Minireview: The adipocyte--at the crossroads of energy homeostasis, inflammation, and atherosclerosis.

          Michael W. Rajala, Philipp Scherer (2003)
          Adipose tissue evolved to efficiently store energy for times of caloric restriction. The large caloric excess common in many Western diets has negated the need for this thrifty function, leaving adipose tissue ill-equipped to handle this increased load. An excess of adipose tissue increases risk for a number of conditions including coronary artery disease, hypertension, dyslipidemias, type 2 diabetes, and even cancer. Indeed, the ability of the adipocyte to function properly when engorged with lipid can lead to lipid accumulation in other tissues, reducing their ability to function and respond normally. The role of adipose tissue as an endocrine organ capable of secreting a number of adipose tissue-specific or enriched hormones, known as adipokines, is gaining appreciation. The normal balance of these adipose tissue secretory proteins is perturbed in obesity. Paradoxically, the lack of normal adipose tissue, as seen in cases of lipodystrophy and lipoatrophy, is also associated with pathologic sequelae similar to what is seen with obesity. The pathologic findings associated with lack of adipose tissue, largely due to inability to properly store lipids, may also be due to a lack of adipokines. In this review, we highlight the role of adipose tissue as an endocrine organ focusing on some of the recent advances in the identification and pharmacological characterization of adipokines as well as their regulation in the context of obesity and insulin-resistant states.
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            Reciprocal association of C-reactive protein with adiponectin in blood stream and adipose tissue.

            Hisatoyo Hiraoka, Noriyuki Ouchi, Tohru Funahashi … (2003)
            High-sensitive C-reactive protein (hs-CRP) is a well-known risk factor for coronary artery disease (CAD). Recently, we have demonstrated that adiponectin served as an antiatherogenic plasma protein which was secreted specifically from adipocytes. The present study investigated the association between adiponectin and CRP in the blood stream and adipose tissue. We studied a total of 101 male patients, 71 of whom had angiographically documented coronary atherosclerosis. As a control group, 30 patients with normal coronary angiogram were included. The plasma hs-CRP levels were negatively correlated with the plasma adiponectin levels (r=-0.29, P<0.01). The plasma adiponectin concentrations were significantly lower and the hs-CRP levels were significantly higher in the CAD patients compared with control subjects. The mRNA levels of CRP and adiponectin were analyzed by quantitative real-time polymerase chain reaction method. We found that the CRP mRNA was expressed in human adipose tissue. A significant inverse correlation was observed between the CRP and adiponectin mRNA levels in human adipose tissue (r=-0.89, P<0.01). In addition, the CRP mRNA level of white adipose tissue in adiponectin deficient mice was higher than that of wild-type mice. The reciprocal association of adiponectin and CRP levels in both human plasma and adipose tissue might participate in the development of atherosclerosis.
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              Plasma leptin and the risk of cardiovascular disease in the west of Scotland coronary prevention study (WOSCOPS).

              Heath A. Kelly, N Sattar, Alex Shepherd … (2001)
              Leptin plays a role in fat metabolism and correlates with insulin resistance and other markers of the metabolic syndrome, independent of total adiposity. Therefore, we hypothesized that raised leptin levels may identify men at increased risk of a coronary event in the West of Scotland Coronary Prevention Study (WOSCOPS). Methods and Results- Plasma leptin levels were measured at baseline in 377 men (cases) who subsequently experienced a coronary event and in 783 men (controls) who remained free of an event during the 5-year follow-up period of the study. Controls were matched to cases on the basis of age and smoking history and were representative of the entire WOSCOPS cohort. Leptin levels were significantly higher in cases than controls (5.87+/-2.04 ng/mL versus 5.04+/-2.09 ng/mL, P<0.001). In univariate analysis, for each 1 SD increase in leptin, the relative risk (RR) of an event increased by 1.25 (95% confidence interval [CI], 1.10 to 1.43; P<0.001). There was minimal change in this RR with correction for body mass index (RR, 1.24; 95% CI, 1.06 to 1.45; P=0.006) or with further correction for classic risk factors, including age, lipids, and systolic blood pressure (RR, 1.20; 95% CI, 1.02 to 1.42; P=0.03). Leptin correlated with C-reactive protein (r=0.24, P<0.001) and, even with this variable added to the model, leptin retained significance as a predictor of coronary events (RR, 1.18; 95% CI, 1.00 to 1.39; P=0.05) at the expense of C-reactive protein. We show, for the first time, in a large prospective study that leptin is a novel, independent risk factor for coronary heart disease.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Arq Bras Cardiol
                Journal ID (iso-abbrev): Arq. Bras. Cardiol
                Journal ID (publisher-id): abc
                Title: Arquivos Brasileiros de Cardiologia
                Publisher: Sociedade Brasileira de Cardiologia - SBC
                ISSN (Print): 0066-782X
                ISSN (Electronic): 1678-4170
                Publication date (Print and electronic): October 2016
                Publication date (Print): October 2016
                Volume: 107
                Issue: 4
                Pages: 348-353
                Affiliations
                [1 ]Pregnancy Health Research Center - Departament of Nutrition - School of Medicine - Zahedan University of Medical Sciences; Zahedan, Irã
                [2 ]Departament of Cardiology School of Medicine - Zahedan University of Medical Sciences; Zahedan, Irã
                [3 ]School of Medicine - Zahedan University of Medical Sciences; Zahedan, Irã
                [4 ]Health Promotion Research Center - Departament of Nutrition - School of Medicine - Zahedan University of Medical Sciences, Zahedan, Irã
                Author notes
                Mailing Address: Farzaneh Montazerifar and Mansour Karajibani , Department of Nutrition - School of Medicine - Zahedan University of Medical Sciences, Zahedan - Iran. E-mail: fmontazerifar@ 123456gmail.com
                Article
                DOI: 10.5935/abc.20160134
                PMC ID: 5102481
                PubMed ID: 27627223
                SO-VID: c6ca1cbb-0473-447e-8ee6-44f3f76fa6bc
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 21 January 2016
                Date revision received : 11 February 2016
                Date accepted : 02 June 2016
                Categories
                Subject: Original Articles
                Subject: Metabolism / Nutrition

                Keywords: coronary artery disease,obesity,resistin,leptin,atherosclerosis
                Data availability:
                Keywords: coronary artery disease, obesity, resistin, leptin, atherosclerosis

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