Abstract
BackgroundNesfatin-1, a novel adipokine and dipeptidyl peptidase-4 (DPP4), a mam malian serine protease, are potent factors of atherosclerosis. In the present cross-sectional study, we investigated whether the plasma nesfatin-1 and DPP4 is associated with the prevalence and severity of coronary artery disease (CAD) with and without diabetes mellitus (DM).MethodsWe consecutively enrolled a total of 240 patients with significant CAD (previous revascularization or angiographically-proven coronary artery stenosis > 50%) presented with either unstable angina (UA, N = 76) or stable chronic CAD (SCAD, N = 165). 85 patients with at least 2 classical cardiovascular risk factors but without significant CAD served as controls. The severity of CAD was assessed using coronary angiography by the Gensini score. Clinical parameters, glycemic and lipid profile, high-sensitivity CRP (hsCRP), nesfatin-1 and DPP4 levels were assayed.ResultsNo differences were found for age, sex, hypertension and diabetes distribution between groups. Low nesfatin-1 levels were found in both CAD groups (UA & SCAD) with respect to controls. The difference between UA and SCAD groups was marginally non-significant. There was a significant increase of DPP4 along UA to SCAD and control groups. Differences between groups remained unchanged in non-diabetic participants. Nesfatin-1 significantly correlated to hsCRP (r = − 0.287, p = 0.036), HOMA-IR (r = − 0.587, p = 0.007) and hyperlipidemia (r = − 0.331, p = 0.034). DPP4 was significantly associated with hs-CRP (r = 0.353 p < 0.001) and FPG (r = 0.202, p = 0.020) in univariate analysis, but those correlations were lost in multiple regression analysis. There was a negative correlation between nesfatin-1 and the severity of CAD, quantified by the Gensini score (r = − 0.511, p < 0.001), but no association was found for DPP4.ConclusionsSerum DPP4 levels are increased in patients with CAD, while serum nesfatin-1 levels have a negative association with both the incidence and the severity of CAD. These results are independent of the presence of diabetes mellitus. In addition, both peptides have a strong association with hsCRP.Trial registration ClinicalTrials.gov Identifier: NCT00306176
Highlights
Nesfatin-1 is a relatively novel adipokine which was discovered by Oh et al [1]
Groups comparison After initial evaluation and exclusion criteria application we considered eligible 76 patients for unchanged in nondiabetic participants (UA) group, 165 patients for Stable coronary artery disease (SCAD) group and 85 patients for control group
Baseline characteristics of all participants are summarized in Table 1: no differences were found for age, sex hypertension and diabetes distribution between groups
Summary
Nesfatin-1 is a relatively novel adipokine which was discovered by Oh et al [1]. It is secreted from the hypothalamic nuclei and it was initially considered a satiety molecule which exerts anorexigenic effects through the Kadoglou et al Cardiovasc Diabetol (2021) 20:166 melanocortin system, being decreased by fasting and increased on refeeding [2]. Human studies have shown a consistent association of nesfatin-1 levels with high-sensitive C-reactive protein (hsCRP), and low-grade inflammatory conditions like atherosclerosis, insulin resistance and, even more interestingly, CAD severity [3]. In the present cross-sectional study, we investigated whether the plasma nesfatin-1 and DPP4 is associated with the prevalence and severity of coronary artery disease (CAD) with and without diabetes mellitus (DM)
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