First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy; Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, 8952 Schlieren, Switzerland.
First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy.
Vascul Pharmacol. 2018 Mar;102:37-43. doi: 10.1016/j.vph.2017.12.066. Epub 2018 Jan 2.
As endocrine organ, adipose tissue may modulate inflammatory response by releasing a wide range of mediators, known as adipocytokines. Due to the complex balance between pro- and anti-inflammatory activity their pathophysiological and prognostic role in cardiovascular (CV) diseases still remains debated. Here, we consider the potential associations of circulating adipocytokines adiponectin, leptin and their ratio (LAR), with metabolic and inflammatory profiles in 217 patients with severe carotid stenosis. A prospective analysis investigating their predictive role toward acute coronary syndromes (ACS) was also drawn over a 12-month follow-up period. Serum leptin was positively associated with fasting insulinemia and HOMA-IR, but not with lipid profile and inflammation. Conversely, adiponectin was negatively associated with glucose, insulin, HOMA-IR, triglycerides and both systemic and intraplaque inflammatory markers whereas a positive association with high-density lipoprotein cholesterol (HDL-c) was observed. Accordingly, a significant association with metabolic profile was reported for LAR. According to the cut-off point identified by ROC curve, adiponectin values≤2.56μg/mL were correlated with a higher risk of ACS occurrence at 12months' follow-up (p-value for Log Rank test=0.0003). At Cox regression analysis the predictive ability of low serum adiponectin was confirmed also after adjustment for age, male gender and diabetes. In conclusion, adiponectin may be considered a biomarker of metabolic compensation, inversely associated with chronic low-grade inflammation. Circulating adiponectin is also associated with lower risk of adverse CV events in patients with severe carotid stenosis.
作为内分泌器官，脂肪组织通过释放广泛的介质（称为脂肪细胞因子）来调节炎症反应。由于促炎和抗炎活性之间的复杂平衡，它们在心脑血管疾病中的病理生理和预后作用仍存在争议。在这里，我们考虑了循环脂肪细胞因子脂联素、瘦素及其比值 (LAR) 与 217 例严重颈动脉狭窄患者代谢和炎症特征之间的潜在关联。还在 12 个月的随访期间进行了前瞻性分析，以研究它们对急性冠状动脉综合征 (ACS) 的预测作用。
血清瘦素与空腹胰岛素血症和 HOMA-IR 呈正相关，但与血脂谱和炎症无关。相反，脂联素与血糖、胰岛素、HOMA-IR、甘油三酯以及全身和斑块内炎症标志物呈负相关，而与高密度脂蛋白胆固醇 (HDL-c) 呈正相关。因此，LAR 与代谢特征有显著相关性。根据 ROC 曲线确定的截断点，脂联素值≤2.56μg/mL 与 12 个月随访时 ACS 发生的风险增加相关（对数秩检验的 p 值=0.0003）。在 Cox 回归分析中，在调整年龄、男性和糖尿病后，低血清脂联素的预测能力也得到了证实。
总之，脂联素可以被认为是代谢补偿的生物标志物，与慢性低度炎症呈负相关。循环脂联素也与严重颈动脉狭窄患者不良心血管事件风险降低相关。
