Abstract
Background and Aims. The secretion of several adipocytokines, such as adiponectin, retinol-binding protein 4 (RBP4), adipocyte fatty acid binding protein (aFABP), and visfatin, is altered in subjects with abdominal adiposity; these endocrine alterations could contribute to increased cardiovascular risk. The aim of the study was to assess the relationship among adiponectin, RBP4, aFABP, and visfatin, and incident cardiovascular disease. Methods and Results. A case-control study, nested within a prospective cohort, on 2945 subjects enrolled for a diabetes screening program was performed. We studied 18 patients with incident fatal or nonfatal IHD (Ischemic Heart Disease) or CVD (Cerebrovascular Disease), compared with 18 matched control subjects. Circulating adiponectin levels were significantly lower in cases of IHD with respect to controls. Circulating RBP4 levels were significantly increased in CVD and decreased in IHD with respect to controls. Circulating aFABP4 levels were significantly increased in CVD, while no difference was associated with IHD. Circulating visfatin levels were significantly lower in cases of both CVD and IHD with respect to controls, while no difference was associated with CVD. Conclusions. The present study confirms that low adiponectin is associated with increased incidents of IHD, but not CVD, and suggests, for the first time, a major effect of visfatin, aFABP, and RBP4 in the development of cardiovascular disease.
Highlights
Overweight and obesity are associated with a different secretion rate of several adipocytokines, such as reduced adiponectin [1] and increased retinol-binding protein 4 (RBP4) [2], adipocyte fatty acid binding protein [3], and visfatin [4]. aFABP plays an important role in maintaining glucose and lipid homeostasis. aFABP has been primarily regarded as an adipocyte- and macrophage-specific protein, but recent studies suggest that it may be more widely expressed [5]
Since visceral adiposity and insulin resistance are known to be associated with increased cardiovascular risk [16], it could be speculated that some adipocytokines mediate this relationship
Present data confirm that low adiponectin is an independent predictor of IHD, even after adjustment for components of the metabolic syndrome; on the other hand, adiponectin levels are not associated with the incidence of CVD
Summary
Overweight and obesity are associated with a different secretion rate of several adipocytokines, such as reduced adiponectin [1] and increased retinol-binding protein 4 (RBP4) [2], adipocyte fatty acid binding protein (aFABP) [3], and visfatin [4]. aFABP plays an important role in maintaining glucose and lipid homeostasis. aFABP has been primarily regarded as an adipocyte- and macrophage-specific protein, but recent studies suggest that it may be more widely expressed [5]. AFABP has been primarily regarded as an adipocyte- and macrophage-specific protein, but recent studies suggest that it may be more widely expressed [5] Such endocrine modifications could be responsible, at least partly, for the increased cardiovascular risk associated with excess fat mass [6]. The secretion of several adipocytokines, such as adiponectin, retinol-binding protein 4 (RBP4), adipocyte fatty acid binding protein (aFABP), and visfatin, is altered in subjects with abdominal adiposity; these endocrine alterations could contribute to increased cardiovascular risk. Circulating visfatin levels were significantly lower in cases of both CVD and IHD with respect to controls, while no difference was associated with CVD. The present study confirms that low adiponectin is associated with increased incidents of IHD, but not CVD, and suggests, for the first time, a major effect of visfatin, aFABP, and RBP4 in the development of cardiovascular disease
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