Abstract
BackgroundInflammation has been recognized as a key feature of both type 2 diabetes mellitus (T2DM) and atherosclerosis. However, the relationships between circulating levels of novel adipose tissue-derived inflammatory factors, including resistin, vaspin, and visfatin, and the severity of atherosclerosis have not been determined. Moreover, the associations between these inflammatory factors and obesity and insulin resistance in elderly patients remain to be clarified.MethodsA cross-sectional study of 256 elderly patients with T2DM admitted in our center was performed. Baseline circulating levels of resistin, vaspin and visfatin were measured with enzyme-linked immunosorbent assays. Ultrasonic evaluations of the carotid arteries of the patients were performed to reflect the severity of systemic atherosclerosis. Patients were classified as having mild, moderate, or severe atherosclerosis according to the results of carotid ultrasonic examination. Circulating levels of the inflammatory factors listed above also were correlated with body mass index (BMI) and homeostasis model assessment of insulin resistance (HOMA-IR).ResultsWith more severe carotid atherosclerosis, circulating levels of resistin (mild: 2.01 ± 0.23; moderate: 2.89 ± 1.01; severe: 3.12 ± 1.12; p < 0.05) and visfatin (mild: 11.63 ± 7.48; moderate: 15.24 ± 2.19; severe: 17.54 ± 2.98; p < 0.05) gradually increased, while level of vaspin decreased (mild: 317 ± 23.12; moderate: 269 ± 32.12; severe: 229 ± 14.24; p < 0.05). Subsequent results of Pearson coefficient analyses indicated that all of the tested adipose tissue-derived inflammatory factors were positively correlated with the BMI and HOMA-IR of the patients (all p < 0.05), even after adjustment for hs-CRP.ConclusionsThe adipose tissue-derived inflammatory factors resistin, vaspin and visfatin may be involved in the pathogenesis of atherosclerosis in elderly T2DM patients.
Highlights
Inflammation has been recognized as a key feature of both type 2 diabetes mellitus (T2DM) and atherosclerosis
Characteristics of the patients according to the severity of carotid atherosclerosis Overall, our study included 256 elderly patients with T2DM who were admitted in our hospital, of which 87, 105, and 64 patients were allocated to the mild, moderate, and severe atherosclerosis groups according to the findings of ultrasonic examination of the carotid arteries
Subsequent analyses after adjustment for high-sensitivity C-reactive protein (hs-CRP) showed similar results (Table 4), suggesting the correlations of the above adipose tissuederived inflammatory factors with body mass index (BMI) and homeostasis model assessment of insulin resistance (HOMA-IR) were independent of the systematic inflammation index. In this cross-sectional study of elderly patients with T2DM, we found that circulating levels of novel adipose tissue-derived inflammatory factors showed a trend of significant change according to the severity of systemic atherosclerosis
Summary
Inflammation has been recognized as a key feature of both type 2 diabetes mellitus (T2DM) and atherosclerosis. Recent evidence suggests that in addition to storing energy, adipose tissue may secrete several inflammatory factors, such as resistin, vaspin and visfatin, which may be important mediators of obesity, atherosclerosis, and DM [21, 22]. Resistin was initially discovered as an adipocyte-secreted hormone mediating obesity and insulin resistance in animal studies, and a recently published study in humans suggests its potential role in the pathogenesis of atherosclerosis [23]. The aim of the current retrospective cohort study was to compare the levels of resistin, vaspin, and visfatin in T2DM patients according to the severity of carotid atherosclerosis and to explore the potential relationships of these factors and the conventional risk factors for T2DM and atherosclerosis, such as body mass index (BMI) and indicators of insulin resistance
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