Abstract
BackgroundThe interplay between the novel adipokine retinol-binding protein-4 (RBP4) and coronary artery disease (CAD) is still obscure. We investigated the relationship between RBP4 levels and the presence and severity of angiographically proven CAD and determined its possible role in acute myocardial infarction (AMI).Methods305 individuals with angiographically proven CAD (CAD-patients), were classified into 2 subgroups: 1) acute myocardial infarction (AMI, n = 141), and 2) stable angina (SA, n = 164). Ninety-one age- and sex-matched individuals without CAD, but with at least 2 classical cardiovascular risk factors, served as controls (non-CAD group). RBP4 serum levels were measured at hospital admission and were analyzed in relation to the coronary severity stenosis, assessed by the Gensini-score and the number of coronary narrowed vessels. Other clinical parameters, including insulin levels, HOMA-IR, hsCRP, glycaemic and lipid profile, and left-ventricular ejection fraction were also assessed.ResultsSerum RBP4 levels were significantly elevated in patients with CAD compared to non-CAD patients (39.29 ± 11.72 mg/L vs. 24.83 ± 11.27 mg/L, p < 0.001). We did not observe a significant difference in RBP4 levels between AMI and SA subgroups (p = 0.734). Logistic regression analysis revealed an independent association of CAD presence with serum RBP4 (β = 0.163, p = 0.006), and hsCRP (β = 0.122, p = 0.022) levels, in the whole study group. Among variables, hsCRP (β = 0.220), HDL (β = −0.150), and RBP4 (β = 0.297), correlated in both univariate and multivariate analysis with CAD severity (R2 = 0.422, p < 0.001). Similarly, RBP4 concentrations increased with the number of coronary narrowed vessels (p < 0.05).ConclusionPatients with CAD, both SA and AMI, showed elevated RBP4 serum levels. Notably, increased RBP4 concentration seemed to independently correlate with CAD severity, but no with AMI.Trial registrationThe ClinicalTrials.gov Identifier is: NCT00636766
Highlights
Coronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide with the risk for coronary artery disease (CAD) development being higher among patients with obesity, diabetes and other insulin resistant states
Based on clinical and laboratory findings, the latter group was further subdivided into the following subgroups: 1) AMI (n = 141): Patients consecutively hospitalized in the coronary care unit of our department with acute myocardial infarction (AMI) (STEMI, NSTEMI) within 12 hours of symptoms onset
We explored the independent determinants of CAD in the whole study group using logistic regression analysis and the receiver operating characteristic (ROC) curve
Summary
Coronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide with the risk for CAD development being higher among patients with obesity, diabetes and other insulin resistant states. A growing body of evidence, the adipocyte-derived cytokines, known as adipokines, seem to interfere with the crosstalk between adipose tissue, insulin resistance and CAD [4]. But not all studies, have demonstrated its link with insulin resistance and obesity [5,6,7]. High RBP4 levels in obese children seem to be related to adipose tissue mass, to the differentiation of adipocytes, and to multiple risk factors for adiposity-related co-morbidities [10,11]. The interplay between the novel adipokine retinol-binding protein-4 (RBP4) and coronary artery disease (CAD) is still obscure. We investigated the relationship between RBP4 levels and the presence and severity of angiographically proven CAD and determined its possible role in acute myocardial infarction (AMI)
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