Contribution of adipocytokines to low-grade inflammatory state as expressed by circulating C-reactive protein in Japanese men: comparison of leptin and adiponectin

Biomarkers of Atrial Fibrillation in Metabolic Syndrome

Whether the increased atrial fibrillation (AF) risk in metabolic syndrome (MetS) patients is due to the syndrome as a whole or simply the sum of the risks of its individual component parts is still obscure. These two clinical entities share many pathophysiological links and thus distinction between a casual observation and a significant association is difficult. Biomarkers associated with pathogenesis of AF in the context of MetS have the ability to refine future risk prediction. In the present review we identify circulating substances that could be regarded as potential biomarkers for prediction of incident AF, or of cardiovascular events in the setting of AF in patients with MetS. Cardiac myocyte injury and stress markers (troponin and natriuretic peptides), markers of renal function (glomeral filtration rate, cystatin-C), and inflammation markers/mediators (interleukin- 6, CRP) are promising biomarkers of patients with AF and MetS.

Pain Intensity and Pain Interference in Older Adults: Role of Gender, Obesity and High-Sensitivity C-Reactive Protein

BACKGROUND

Among older adults, pain intensity and pain interference are more common in women than men and associated with obesity and inflammatory markers.

OBJECTIVE

We examined whether the obesity and pain relationship is mediated by the high-sensitivity C-reactive protein (hsCRP), a nonspecific marker of systemic inflammation, and whether this relationship differs by sex.

METHODS

Items from Medical Outcomes Study Short Form-36 were used to measure pain intensity and pain interference in daily life. Ordinal logistic regression was used to assess the cross-sectional association among body mass index (BMI), hsCRP levels, pain intensity and pain interference using gender-stratified models adjusted for demographic variables.

RESULTS

Participants included 667 community-residing adults over the age of 70 years, free of dementia, enrolled in the Einstein Aging Study (EAS). In women (n = 410), pain intensity was associated with obesity [BMI ≥30 vs. normal, odds ratio (OR) = 2.29, 95% confidence interval (CI) 1.43-3.68] and higher hsCRP (OR = 1.28, 95% CI 1.08-1.51). In a model with obesity and hsCRP, both remained significant, but the association between hsCRP and pain intensity was somewhat attenuated. Obesity (OR = 3.04, 95% CI 1.81-5.11) and higher hsCRP levels (OR = 1.30, 95% CI 1.08-1.56) were also independently associated with greater pain interference in women. After adjustment for pain intensity and BMI, hsCRP was no longer associated with pain interference in women. Greater pain intensity and being overweight or obese continued to be significantly associated with pain interference in women. In men (n = 257), obesity and hsCRP were not associated with pain intensity or pain interference.

CONCLUSIONS

In women, the relationship between obesity and higher levels of pain intensity or interference may be accounted for by factors related to hsCRP.

Plasma adiponectin concentration and its association with metabolic syndrome in patients with heart failure

PURPOSE

Plasma adiponectin concentrations are inversely related with metabolic syndrome (MetS), and MetS is associated with increased risk for heart failure (HF). However, the relationship between adiponectin and MetS in HF remains undetermined. Therefore, we tested whether MetS was associated with the degree of plasma adiponectin concentrations in HF patients.

MATERIALS AND METHODS

One hundred twenty eight ambulatory HF patients with left ventricular ejection fraction of <50% (80 males, 61.8 ± 11.9 years old) were enrolled for this cross-sectional study. Echocardiographic measurements were performed, and plasma concentrations of adiponectin, lipoproteins, apolipoproteins (apoB, apoA1) and high sensitive C-reactive protein (hsCRP) were measured.

RESULTS

Adiponectin concentrations in HF patients with MetS (n=43) were significantly lower than those without MetS (n=85) (9.7 ± 7.0 vs. 15.8 ± 10.9 μg/mL, p=0.001). Higher concentrations of apoB (p=0.017), apoB/A1 ratio (p<0.001), blood urea nitrogen (p=0.034), creatinine (p=0.003), and fasting insulin (p=0.004) were observed in HF patients with MetS compared with those without MetS. In HF patients with MetS, adiponectin concentrations were negatively correlated with hsCRP (r=-0.388, p=0.015) and positively correlated with the ratio of early mitral inflow velocity to early diastolic mitral annular velocity, E/E' (r=0.399, p=0.015). There was a significant trend towards decreased adiponectin concentrations with an increasing number of components of MetS (p for trend=0.012).

CONCLUSION

Our study demonstrated that adiponectin concentrations decreased in HF patients with MetS, and that relationship between adiponectin, inflammation and abnormal diastolic function, possibly leading to the progression of HF.

Pathogenic obesity and nutraceuticals

Over a decade of intense research in the field of obesity has led to the knowledge that chronic, excessive adipose tissue expansion leads to an increase in the risk for CVD, type 2 diabetes mellitus and cancer. This is primarily thought to stem from the low-grade, systemic inflammatory response syndrome that characterises adipose tissue in obesity, and this itself is thought to arise from the complex interplay of factors including metabolic endotoxaemia, increased plasma NEFA, hypertrophic adipocytes and localised hypoxia. Plasma concentrations of vitamins and antioxidants are lower in obese individuals than in the non-obese, which is hypothesised to negatively affect the development of inflammation and disease in obesity. This paper provides a review of the current literature investigating the potential of nutraceuticals to ameliorate the development of oxidative stress and inflammation in obesity, thereby limiting the onset of obesity complications. Research has found nutraceuticals able to positively modulate the activity of adipocyte cell lines and further positive effects have been found in other aspects of pathogenic obesity. While their ability to affect weight loss is still controversial, it is clear that they have a great potential to reverse the development of overweight and obesity-related comorbidities; this, however, still requires much research especially that utilising well-structured randomised controlled trials.

Adiponectin may improve osseointegration of dental implants in T2DM patients

Type 2 diabetes mellitus (T2DM) is the most common form of diabetes. Compared with the general population, a higher failure rate is seen in T2DM patients. There is also evidence that chronically high levels of plasma glycemia leads to inflammatory effect and a negative influence on bone formation and remodeling, and reduce osseointegration of implants. Recently studies reveal that adiponectin is an insulin-sensitizing adipokine, and closely associated with T2DM. Adiponectin has potent anti-inflammatory properties and has been shown to increase bone density by inhibiting osteoclast formation and promoting the formation of osteoblasts. We therefore hypothesize systemically infused or locally used adiponectin could accelerate osseointegration of dental implants in T2DM. Our hypothesis could help to create an option to improve success ratio of dental implants in T2DM by the replenishment of adiponectin in T2DM patients.

Influence of smoking and body weight on adipokines in middle aged women

Objective

Quitting smoking was associated with an undesirable weight gain. Both, cigarette smoking and obesity were accompanied by subclinical systemic inflammation. This may cause unfavourable changes in (plasma) adipokine concentration. The aim of the present study was to establish the influence of moderate cigarette smoking on the concentration of the adipokines leptin and adiponectin and the pro-inflammatory factors CRP, SAA, IL-6 and TNF-α in non-obese (n = 138) and obese (n = 175) perimenopausal women of the DRECAN-2005 survey.

Results

Among non-obese women, adiponectin was significantly lower in smokers than in non-smokers (16.88 ± 6.85 vs. 20.63 ± 10.04 μg/ml; P < 0.05). Leptin tended to lower values, too. Among obese women, none significant differences in adiponectin or leptin concentration were observed between smokers and non-smokers. In obese smokers and obese non-smokers, the adiponectin concentrations were significantly lower and the leptin concentrations were significantly higher than in non-obese non-smokers. Non-obese smokers showed significantly higher leukocyte count (6.50 ± 1.83 vs. 5.51 ± 1.31 GPT/l; P < 0.001) and serum amyloid A concentration (7.81 ± 1.25 vs. 4.22 ± 1.43 mg/l; P < 0.05) than non-obese non-smokers. There were only tendencies to higher concentration of CRP, IL-6, and TNF-α. In obese women, moderate cigarette smoking was not associated with higher leukocyte count or concentration of SAA. Among non-smokers, overweight was associated higher concentration of leptin (22.16 ± 12.16 vs. 11.49 ± 6.37 ng/ml; P < 0.001) and with significantly lower concentration of adiponectin (16.29 ± 8.01 vs. 20.77 ± 9.99 μg/ml; P < 0.001). Among smokers, overweight was associated with higher leptin concentration only (obese: 18.62 ± 13.46 vs. non-obese: 8.84 ± 4.92 ng/ml; P < 0.01).

Conclusions

In non-obese middle aged women, even moderate cigarette smoking adversely influences the serum concentration of adiponectin and SAA. Over-weight hides possible effects of smoking on cytokines and adipokines.

Human C-reactive protein and the metabolic syndrome

PURPOSE OF REVIEW

Low-grade inflammation is characteristic of the metabolic syndrome (MetS). C-reactive protein (CRP), the best characterized biomarker of inflammation, is also an independent predictor of future cardiovascular events. The purpose of this review is to outline the role of inflammation and high sensitivity CRP in the MetS.

RECENT FINDINGS

Emerging laboratory and epidemiological data now link inflammation and high sensitivity CRP to insulin resistance and adiposity and other features of MetS. Furthermore, in large prospective studies, increased high sensitivity CRP levels in MetS confer greater cardiovascular risk. CRP has been shown to impair insulin signaling and contributes to atherothrombosis.

SUMMARY

Thus, although a high CRP level predisposes to increased cardiovascular risk in MetS, future investigation is warranted on the in-vivo role of CRP in mediating vascular effects and resulting in increased cardiovascular events in MetS patients.