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Adiponectin and Cognitive Decline. Int J Mol Sci 2020; 21:ijms21062010. [PMID: 32188008 PMCID: PMC7139651 DOI: 10.3390/ijms21062010] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/10/2020] [Accepted: 03/13/2020] [Indexed: 12/11/2022] Open
Abstract
Adiponectin (ADPN) is a plasma protein secreted by adipose tissue showing pleiotropic effects with anti-diabetic, anti-atherogenic, and anti-inflammatory properties. Initially, it was thought that the main role was only the metabolism control. Later, ADPN receptors were also found in the central nervous system (CNS). In fact, the receptors AdipoR1 and AdipoR2 are expressed in various areas of the brain, including the hypothalamus, hippocampus, and cortex. While AdipoR1 regulates insulin sensitivity through the activation of the AMP-activated protein kinase (AMPK) pathway, AdipoR2 stimulates the neural plasticity through the activation of the peroxisome proliferator-activated receptor alpha (PPARα) pathway that inhibits inflammation and oxidative stress. Overall, based on its central and peripheral actions, ADPN appears to have neuroprotective effects by reducing inflammatory markers, such as C-reactive protein (PCR), interleukin 6 (IL6), and Tumor Necrosis Factor a (TNFa). Conversely, high levels of inflammatory cascade factors appear to inhibit the production of ADPN, suggesting bidirectional modulation. In addition, ADPN appears to have insulin-sensitizing action. It is known that a reduction in insulin signaling is associated with cognitive impairment. Based on this, it is of great interest to investigate the mechanism of restoration of the insulin signal in the brain as an action of ADPN, because it is useful for testing a possible pharmacological treatment for the improvement of cognitive decline. Anyway, if ADPN regulates neuronal functioning and cognitive performances by the glycemic metabolic system remains poorly explored. Moreover, although the mechanism is still unclear, women compared to men have a doubled risk of developing cognitive decline. Several studies have also supported that during the menopausal transition, the estrogen reduction can adversely affect the brain, in particular, verbal memory and verbal fluency. During the postmenopausal period, in obese and insulin-resistant individuals, ADPN serum levels are significantly reduced. Our recent study has evaluated the relationship between plasma ADPN levels and cognitive performances in menopausal women. Thus, the aim of this review is to summarize both the mechanisms and the effects of ADPN in the central nervous system and the relationship between plasma ADPN levels and cognitive performances, also in menopausal women.
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Chen R, Shu Y, Zeng Y. Links Between Adiponectin and Dementia: From Risk Factors to Pathophysiology. Front Aging Neurosci 2020; 11:356. [PMID: 31969813 PMCID: PMC6960116 DOI: 10.3389/fnagi.2019.00356] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 12/05/2019] [Indexed: 12/12/2022] Open
Abstract
With the aging population, dementia is becoming one of the most serious and troublesome global public health issues. Numerous studies have been seeking for effective strategies to delay or block its progression, but with little success. In recent years, adiponectin (APN) as one of the most abundant and multifunctional adipocytokines related to anti-inflammation, regulating glycogen metabolism and inhibiting insulin resistance (IR) and anti-atherosclerosis, has attracted widespread attention. In this article, we summarize recent studies that have contributed to a better understanding of the extent to which APN influences the risks of developing dementia as well as its pathophysiological progression. In addition, some controversial results interlinked with its effects on cognitive dysfunction diseases will be critically discussed. Ultimately, we aim to gain a novel insight into the pleiotropic effects of APN levels in circulation and suggest potential therapeutic target and future research strategies.
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Affiliation(s)
- RuiJuan Chen
- Department of Geriatrics, Second Xiangya Hospital, Central South University, Changsha, China
| | - Yi Shu
- Department of Neurology, Second Xiangya Hospital, Central South University, Changsha, China
| | - Yi Zeng
- Department of Geriatrics, Second Xiangya Hospital, Central South University, Changsha, China
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Liao WL, Chen YH, Chen CC, Huang YC, Lin HJ, Chen YT, Ban B, Wu CM, Chang YW, Hsieh AR, Tsai FJ. Effect of adiponectin level and genetic variation of its receptors on diabetic retinopathy: A case-control study. Medicine (Baltimore) 2019; 98:e14878. [PMID: 30882695 PMCID: PMC6426570 DOI: 10.1097/md.0000000000014878] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Adiponectin (APN) and its receptors have been reported to be associated with metabolic phenotypes. To better understand the effects of APN levels and its receptors on diabetic retinopathy (DR), we investigated the association of the plasma APN level and variations in APN-related genes with DR, individually and in combination.Patients with type 2 diabetes (T2D; N = 1604), above 20 years of age from the Taiwanese population participated in the study. Demographic information, blood pressure, and serological markers were recorded at enrollment. Genomic DNA was isolated and genotyped. The plasma APN levels were measured by enzyme-linked immunosorbent assay.T2D patients with DR (N = 632) had diabetes for a longer duration, and had higher HbA1c, and systolic and diastolic blood pressure compared to those without DR (N = 972) (P < .001, for all the parameters). Overall, 10 single nucleotide polymorphisms (SNPs) in ADIPOQ and CDH13 susceptibility loci were associated with DR. Gene risk score (GRS) was calculated based on 10 SNPs for each subject and the cumulative effect of genes was observed. Among the subjects with plasma APN level (N = 518), natural logarithm (LN) of APN (LN [APN]; odds ratio [OR] = 1.63, 95% confidence interval [CI] = 1.19-2.25) and GRS (OR = 1.90, 95% CI = 1.11-3.26 for middle range of GRS, and OR = 2.61, 95% CI = 1.48-4.59 for high range of GRS) were independent risk factors for DR after adjustment for other parameters.In conclusion, the plasma APN level and the genetic variations in adiponectin receptors were associated with DR.
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Affiliation(s)
- Wen-Ling Liao
- Graduate Institute of Integrated Medicine, China Medical University
- Center for Personalized Medicine, China Medical University Hospital
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, China Medical University
- Chinese Medicine Research Center, Research Center for Chinese Medicine & Acupuncture, China Medical University
- Department of Medical Research, China Medical University Hospital
- Department of Psychology, College of Medical and Health Science, Asia University
| | - Ching-Chu Chen
- School of Chinese Medicine, China Medical University
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital
| | - Yu-Chuen Huang
- School of Chinese Medicine, China Medical University
- Human Genetic Center, Department of Medical Research, China Medical University Hospital, China Medical University
| | - Hui-Ju Lin
- School of Chinese Medicine, China Medical University
- Department of Ophthalmology, China Medical University Hospital
| | - Yng-Tay Chen
- Graduate Institute of Food Safety, National Chung Hsing University, Taichung, Taiwan
| | - Bo Ban
- Department of Endocrinology, Affiliated Hospital of Jining Medical University
- Chinese Research Center for Behavior Medicine in Growth and Development, Jining, Shandong, China
| | - Chia-Ming Wu
- Human Genetic Center, Department of Medical Research, China Medical University Hospital, China Medical University
| | - Ya-Wen Chang
- Human Genetic Center, Department of Medical Research, China Medical University Hospital, China Medical University
| | - Ai-Ru Hsieh
- Graduate Institute of Biostatistics, Department of Public Health, China Medical University
| | - Fuu-Jen Tsai
- School of Chinese Medicine, China Medical University
- Human Genetic Center, Department of Medical Research, China Medical University Hospital, China Medical University
- Division of Pediatrics Genetics, China Medical University Children's Hospital, Taichung, Taiwan
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Intracranial atherosclerotic disease. Neurobiol Dis 2018; 124:118-132. [PMID: 30439443 DOI: 10.1016/j.nbd.2018.11.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 10/25/2018] [Accepted: 11/09/2018] [Indexed: 12/16/2022] Open
Abstract
Intracranial atherosclerosis (ICAS) is a progressive pathological process that causes progressive stenosis and cerebral hypoperfusion and is a major cause of stroke occurrence and recurrence around the world. Multiple factors contribute to the development of ICAS. Angiography imaging techniques can improve the diagnosis of and the selection of appropriate treatment regimens for ICAS. Neither aggressive medication nor endovascular interventions can eradicate stroke recurrence in patients with ICAS. Non-pharmacological therapies such as remote ischemic conditioning and hypothermia are emerging. Comprehensive therapy with medication in combination with endovascular intervention and/or non-pharmacological treatment may be a potential strategy for ICAS treatment in the future. We summarized the epidemiology, pathophysiological mechanisms, risk factors, biomarkers, imaging and management of ICAS.
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Meadows KL. Ischemic stroke and select adipose-derived and sex hormones: a review. Hormones (Athens) 2018; 17:167-182. [PMID: 29876798 DOI: 10.1007/s42000-018-0034-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 04/27/2018] [Indexed: 02/03/2023]
Abstract
Ischemic stroke is the fifth leading cause of death in the USA and is the leading cause of serious, long-term disability worldwide. The principle sex hormones (estrogen, progesterone, and testosterone), both endogenous and exogenous, have profound effects on various stroke outcomes and have become the focus of a number of studies evaluating risk factors and treatment options for ischemic stroke. In addition, the expression of other hormones that may influence stroke outcome, including select adipose-derived hormones (adiponectin, leptin, and ghrelin), can be regulated by sex hormones and are also the focus of several ischemic stroke studies. This review aims to summarize some of the preclinical and clinical studies investigating the principle sex hormones, as well as select adipose-derived hormones, as risk factors or potential treatments for ischemic stroke. In addition, the potential for relaxin, a lesser studied sex hormone, as a novel treatment option for ischemic stroke is explored.
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Affiliation(s)
- Kristy L Meadows
- Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Rd., North Grafton, MA, 01536, USA.
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Bouziana SD, Tziomalos K, Goulas A, Vyzantiadis TA, Panderi A, Ηatzitolios AΙ. Major Adipokines and the −420C>G Resistin Gene Polymorphism as Predictors of Acute Ischemic Stroke Severity and In-Hospital Outcome. J Stroke Cerebrovasc Dis 2018; 27:963-970. [DOI: 10.1016/j.jstrokecerebrovasdis.2017.10.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 09/26/2017] [Accepted: 10/31/2017] [Indexed: 12/14/2022] Open
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Behrouzifar S, Vakili A, Bandegi AR, Kokhaei P. Neuroprotective nature of adipokine resistin in the early stages of focal cerebral ischemia in a stroke mouse model. Neurochem Int 2018; 114:99-107. [DOI: 10.1016/j.neuint.2018.02.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/22/2018] [Accepted: 02/01/2018] [Indexed: 11/25/2022]
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Adiponectin Single Nucleotide Polymorphisms and Serum Levels Are Relevant to Prognosis of Patients With Aneurysmal Subarachnoid Hemorrhages. Am J Ther 2018; 24:e308-e316. [PMID: 26760913 DOI: 10.1097/mjt.0000000000000437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To investigate the association of adiponectin gene polymorphisms and its levels with aneurysmal subarachnoid hemorrhages (aSAHs) prognosis. This case-control study enrolled 138 patients with aSAH and 102 healthy controls as case group and control group, respectively. Prognosis of case group was evaluated using Glasgow Outcome Scale. Polymerase chain reaction-restriction fragment length polymorphism was used to examine the genotypes of 45T>G and -11377C>G. Enzyme-linked immunosorbent assay was used to detect adiponectin levels. Logistic regression analysis was applied to assess the association of adiponectin gene polymorphism with aSAH prognosis. Case group had increased GG genotype and G allele genotype frequencies of 45T>G and -11377C>G compared with control group (all P < 0.01). In case group, TT genotype had the highest adiponectin level compared with both TG and GC genotypes (both P < 0.05). As for -11377C>G, GG genotype had the lowest adiponectin levels, followed by CG genotype and CC genotype in both groups (P < 0.05). In general, case group had decreased adiponectin levels compared with control group (P < 0.05). Univariate analysis showed that hypertension, Hunt-Hess grade, aneurysm size, aneurysms multiplicity and -11377C>G were associated with aSAH prognosis, while multivariate logistic regression analysis confirmed that hypertension, Hunt-Hess grade, residual flow in aneurysms and aneurysm size were independent risk factors for aSAH prognosis. Decreased adiponectin levels may be a pathological index for aSAH, which may be explain by the G allele of -11377C>G in adiponectin. Moreover, hypertension, Hunt-Hess grade, residual flow in aneurysms and aneurysm size may be independent risk factors for aSAH prognosis.
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Opatrilova R, Caprnda M, Kubatka P, Valentova V, Uramova S, Nosal V, Gaspar L, Zachar L, Mozos I, Petrovic D, Dragasek J, Filipova S, Büsselberg D, Zulli A, Rodrigo L, Kruzliak P, Krasnik V. Adipokines in neurovascular diseases. Biomed Pharmacother 2017; 98:424-432. [PMID: 29278852 DOI: 10.1016/j.biopha.2017.12.074] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 11/20/2017] [Accepted: 12/15/2017] [Indexed: 02/07/2023] Open
Abstract
Adipose tissue is now described as an endocrine organ secreting a number of adipokines contributing to the development of inflammation and metabolic imbalance, but also endothelial dysfunction, vascular remodeling, atherosclerosis, and ischemic stroke. Leptin, adiponectin, and resistin are the most studied adipokines which play important roles in the regulation of cardiovascular homeostasis. Leptin and adiponectin mediate both proatherogenic and antiatherogenic responses. Leptin and adiponectin have been linked to the development of coronary heart disease and may be involved in the underlying biological mechanism of ischemic stroke. Resistin, a pro-inflammatory cytokine, is predictive of atherosclerosis and poor clinical outcomes in patients with coronary artery disease and ischemic stroke. The changes in serum levels of novel adipokines apelin, visfatin are also associated with acute ischemic stroke. These adipokines have been proposed as potential prognostic biomarkers of cardiovascular mortality/morbidity and therapeutic targets in patients with cardiometabolic diseases. In this article, we summarize the biologic role of the adipokines and discuss the link between dysfunctional adipose tissue and metabolic/inflammation imbalance, consequently endothelial damage, progression of atherosclerotic disease, and the occurrence of ischemic stroke.
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Affiliation(s)
- Radka Opatrilova
- Department of Chemical Drugs, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
| | - Martin Caprnda
- 1st Department of Internal Medicine, Faculty of Medicine, Comenius University in Bratislava and University Hospital, Bratislava, Slovakia
| | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia; Department of Experimental Carcinogenesis, Division of Oncology, Biomedical Center Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia
| | | | - Sona Uramova
- Department of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia
| | - Vladimir Nosal
- Department of Neurology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia
| | - Ludovit Gaspar
- 1st Department of Internal Medicine, Faculty of Medicine, Comenius University in Bratislava and University Hospital, Bratislava, Slovakia
| | - Lukas Zachar
- Department of Medical and Clinical Biophysics, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
| | - Ioana Mozos
- Department of Functional Sciences, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Daniel Petrovic
- Institute of Histology and Embryology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Jozef Dragasek
- Department of Psychiatry, Faculty of Medicine, Pavol Jozef Safarik University and University Hospital, Kosice, Slovakia
| | - Slavomira Filipova
- Department of Cardiology, National Institute of Cardiovascular Diseases and Slovak Medical University, Bratislava, Slovakia
| | - Dietrich Büsselberg
- Weill Cornell Medicine in Qatar, Qatar Foundation-Education City, Doha, Qatar
| | - Anthony Zulli
- Centre for Chronic Disease (CCD), College of Health & Biomedicine, Victoria University, Melbourne, Victoria, Australia
| | - Luis Rodrigo
- Faculty of Medicine, University of Oviedo, Central University Hospital of Asturias (HUCA), Oviedo, Spain
| | - Peter Kruzliak
- Department of Chemical Drugs, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic; 2nd Department of Surgery, Faculty of Medicine, Masaryk University and St. Anne´s University Hospital, Brno, Czech Republic.
| | - Vladimir Krasnik
- Department of Ophthalmology, Faculty of Medicine, Comenius University in Bratislava and University Hospital, Bratislava, Slovakia
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Szczepańska-Szerej A, Kurzepa J, Grabarska A, Bielewicz J, Wlizło-Dyś E, Rejdak K. Correlation between CH 2DS 2-VASc Score and Serum Leptin Levels in Cardioembolic Stroke Patients: The Impact of Metabolic Syndrome. Int J Endocrinol 2017; 2017:7503763. [PMID: 29225622 PMCID: PMC5684549 DOI: 10.1155/2017/7503763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 09/05/2017] [Accepted: 09/26/2017] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To determine adipokines levels in patients with different etiologic subtypes of acute ischemic stroke (AIS) and metabolic syndrome (MetS) status. METHODS Serum adiponectin, leptin, and resistin levels were determined by ELISA in 99 AIS patients and 59 stroke-free control group subjects. Stroke patients were grouped based on MetS, modified TOAST classification, and CHA2DS2-VASc scale in case of cardioembolic stroke following atrial fibrillation. RESULTS No differences were found in all adipokine serum levels between AIS patients and appropriately matched control group. MetS-AIS patients had significantly higher leptin levels (22.71 ± 19.01 ng/ml versus 8.95 ± 9.22 ng/ml, p < 0.001) and lower adiponectin levels (10.71 ± 8.59 ng/ml versus 14.93 ± 10.95 ng/ml, p < 0.05) than non-MetS-AIS patients. In patients with cardioembolic stroke, leptin levels were significantly higher than in remaining stroke cases (19.57 ± 20.53 ng/ml versus 13.17 ± 12.36 ng/ml, p < 0.05) and CHA2DS2-VASc score positively correlated with leptin levels only (p < 0.001). Analysis of individual components of CHA2DS2-VASc score showed that hypertension, female gender, and diabetes had greatest impact on elevated serum leptin level. CONCLUSION This pilot study revealed that leptin could be a potential biomarker for risk stratification of cardioembolic stroke in MetS patients and that heterogeneity of stroke subtypes should be considered for more refined and precise clinical stroke studies.
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Affiliation(s)
| | - Jacek Kurzepa
- Department of Medical Chemistry, Medical University of Lublin, Lublin, Poland
| | - Aneta Grabarska
- Department of Biochemistry and Molecular Biology, Medical University of Lublin, Lublin, Poland
| | - Joanna Bielewicz
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - Ewa Wlizło-Dyś
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland
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Abstract
Leptin is a peptide hormone produced by adipose tissue and acts in brain centers to control critical physiological functions. Leptin receptors are especially abundant in the hypothalamus and trigger specific neuronal subpopulations, and activate several intracellular signaling events, including the JAK/STAT, MAPK, PI3K, and mTOR pathway. Although most studies focus on its role in energy intake and expenditure, leptin also plays a critical role in many central nervous system diseases.
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Bouziana S, Tziomalos K, Goulas A, Ηatzitolios AΙ. The role of adipokines in ischemic stroke risk stratification. Int J Stroke 2016; 11:389-98. [DOI: 10.1177/1747493016632249] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 12/09/2015] [Indexed: 11/15/2022]
Abstract
Background Adiponectin, leptin, and resistin are the most well-studied adipokines and play important roles in the regulation of glucose metabolism, subclinical inflammation, and cardiovascular homeostasis. Accordingly, measurement of adipokine levels might be useful in cardiovascular risk stratification. Moreover, the study of single-nucleotide polymorphisms of genes that encode these adipokines might also represent a valuable predictive tool in cardiovascular disease prevention strategies. Aims To summarize the biologic role of the adipokines adiponectin, leptin, and resistin and the prognostic value of their serum levels regarding the occurrence and outcome of ischemic stroke. We also discuss the relationship of single-nucleotide polymorphisms of the adiponectin, leptin genes, and the −420C > G polymorphism of resistin gene with stroke risk. Summary of review Several studies in the general population evaluated the association between these adipokines and stroke risk, yielding conflicting results. There are more limited data regarding the effect of these adipokines on stroke severity and outcome. A small number of studies also assessed the predictive role of single-nucleotide polymorphisms of the adiponectin, leptin, and resistin genes regarding stroke risk, but the findings were also controversial. Conclusions It is unclear whether adiponectin, leptin, and resistin levels or the single-nucleotide polymorphisms of their encoding genes are independently associated with stroke risk. However, given the role of these adipokines in the pathogenesis of atherosclerosis, larger prospective studies, both in the general population and in patients with a history of stroke, are needed to determine whether the measurement of serum levels of these adipokines or the evaluation of single-nucleotide polymorphisms in their encoding genes could improve stroke risk prediction. If this relationship is proven, therapeutic interventions targeting adipokine levels might represent a novel approach to reduce stroke-related mortality and disability.
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Affiliation(s)
- Styliani Bouziana
- First Propedeutic Department of Internal Medicine, AHEPA Hospital, Thessaloniki, Greece
| | | | - Antonios Goulas
- Department of Medicine, First Laboratory of Pharmacology, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Saber H, Himali JJ, Shoamanesh A, Beiser A, Pikula A, Harris TB, Roubenoff R, Romero JR, Kase CS, Vasan RS, Seshadri S. Serum Leptin Levels and the Risk of Stroke: The Framingham Study. Stroke 2015; 46:2881-5. [PMID: 26337973 DOI: 10.1161/strokeaha.115.009463] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 08/05/2015] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND PURPOSE Leptin is a major adipokine that regulates weight balance and energy homeostasis. There is inconsistent evidence linking circulating leptin levels to risk of stroke. We tested the hypothesis that leptin levels are associated with risk of incident stroke in an elderly community based sample. METHODS Serum leptin levels were assayed in 757 stroke free individuals (mean age, 79 years; 62% women) from the Framingham Original Cohort at the 22nd examination cycle (1990-1994). Incidence of all -stroke and ischemic stroke were prospectively ascertained. RESULTS During a mean follow up of 10 years, 119 individuals developed stroke (99 ischemic strokes). In multivariable Cox regression models, log leptin levels were not associated with incidence of all -stroke or ischemic stroke (hazard ratios per SD increment in log leptin 0.90 [0.73-1.09] and 0.89 [0.72-1.11], respectively). The results were suggestive for potential effect modification by waist/hip ratio for the association between leptin and stroke (P=0.03). Adjusting for age, sex, and established stroke risk factors, analysis stratified by waist/hip ratio quartiles revealed a lower incidence of first-ever all-stroke and ischemic stroke associated with higher leptin levels among only subjects in the top waist/hip ratio quartile (hazard ratio, 0.64 [0.43, 0.95] versus 0.98 [0.77, 1.25] for incident all-stroke and 0.61 [0.39, 0.95] versus 0.96 [0.74, 1.26] for ischemic stroke). CONCLUSIONS Leptin levels were not directly related to the risk of incident stroke overall but there was an inverse association with stroke in the top waist/hip ratio quartile. Further investigations are required to confirm these findings and explore possible mechanisms for the observed association.
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Affiliation(s)
- Hamidreza Saber
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.).
| | - Jayandra J Himali
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Ashkan Shoamanesh
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Alexa Beiser
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Aleksandra Pikula
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Tamara B Harris
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Ronenn Roubenoff
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Jose Rafael Romero
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Carlos S Kase
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Ramachandran S Vasan
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
| | - Sudha Seshadri
- From the Framingham Heart Study, MA (H.S., A.B., J.R.R., C.S.K., R.S.V., S.S.); Department of Biostatistics, Boston University School of Public Health, MA (A.B.); Division of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.); Department of Neurology, University of Toronto, Toronto, ON, Canada (A.P.); Geriatric Epidemiology section, National Institute on Aging, National Institute of Health, Bethesda, MD (T.B.H.); Friedman School of Nutrition Science and Policy, Tufts University School of Medicine, Boston, MA (R.R.); and Department of Neurology, Boston University School of Medicine, MA (H.S., J.J.H., A.B., J.R.R., C.S.K., R.S.V., S.S.)
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Kantorová E, Jesenská Ľ, Čierny D, Zeleňák K, Sivák Š, Stančík M, Galajda P, Nosáľ V, Kurča E. The Intricate Network of Adipokines and Stroke. Int J Endocrinol 2015; 2015:967698. [PMID: 26783391 PMCID: PMC4689915 DOI: 10.1155/2015/967698] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 11/02/2015] [Accepted: 11/10/2015] [Indexed: 02/06/2023] Open
Abstract
Cerebrovascular disorders, particularly ischemic stroke, are one of the most common neurological disorders. High rates of overweight and obesity support an interest in the role of adipose tissue and adipose tissue releasing cytokines in inducing associated comorbidities. Adipokines can serve as a key messenger to central energy homeostasis and metabolic homeostasis. They can contribute to the crosstalk between adipose tissue and brain. However recent research has offered ambiguous data on the network of adipose tissue, adipokines, and vascular disorders. In our paper we provide a critical insight into the role of adipokines in evolution of ischemic stroke.
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Affiliation(s)
- Ema Kantorová
- Jessenius Faculty of Medicine, Comenius University, Clinic of Neurology, Malá Hora 4A, 03601 Martin, Slovakia
- *Ema Kantorová:
| | - Ľubica Jesenská
- Jessenius Faculty of Medicine, Comenius University, Department of Medical Biochemistry, Malá Hora 4A, 03601 Martin, Slovakia
| | - Daniel Čierny
- Jessenius Faculty of Medicine, Comenius University, Department of Medical Biochemistry, Malá Hora 4A, 03601 Martin, Slovakia
| | - Kamil Zeleňák
- Jessenius Faculty of Medicine, Comenius University, Clinic of Radiodiagnostics, Malá Hora 4A, 03601 Martin, Slovakia
| | - Štefan Sivák
- Jessenius Faculty of Medicine, Comenius University, Clinic of Neurology, Malá Hora 4A, 03601 Martin, Slovakia
| | - Matej Stančík
- Jessenius Faculty of Medicine, Comenius University, Clinic of Internal Medicine I, Malá Hora 4A, 036 01 Martin, Slovakia
| | - Peter Galajda
- Jessenius Faculty of Medicine, Comenius University, Clinic of Internal Medicine I, Malá Hora 4A, 036 01 Martin, Slovakia
| | - Vladimír Nosáľ
- Jessenius Faculty of Medicine, Comenius University, Clinic of Neurology, Malá Hora 4A, 03601 Martin, Slovakia
| | - Egon Kurča
- Jessenius Faculty of Medicine, Comenius University, Clinic of Neurology, Malá Hora 4A, 03601 Martin, Slovakia
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Kuwashiro T, Ago T, Kamouchi M, Matsuo R, Hata J, Kuroda J, Fukuda K, Sugimori H, Fukuhara M, Awano H, Isomura T, Suzuki K, Yasaka M, Okada Y, Kiyohara Y, Kitazono T. Significance of plasma adiponectin for diagnosis, neurological severity and functional outcome in ischemic stroke - Research for Biomarkers in Ischemic Stroke (REBIOS). Metabolism 2014; 63:1093-103. [PMID: 24929894 DOI: 10.1016/j.metabol.2014.04.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 04/23/2014] [Accepted: 04/29/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Although adiponectin is a major adipocytokine that affects the pathogenesis of various cardiovascular diseases, its clinical significance in stroke remains controversial. We investigated the clinical significance of plasma adiponectin for the diagnosis, neurological severity and functional outcomes of patients with ischemic stroke. METHODS We prospectively enrolled 171 patients with ischemic stroke and 171 age- and sex-matched healthy controls. Blood samples and clinical information were obtained at day 0, 3, 7, 14 and 90 after stroke onset. RESULTS Average adiponectin values at day 0 did not significantly differ between the controls and the patients, but were significantly lower and higher in patients with atherothrombotic brain (ATBI) (p=0.047) and cardioembolic (CE) (p=0.008) infarction, respectively, than in the controls. Multivariate logistic regression analyses showed that the adiponectin value at day 0 could predict ATBI (odds ratio, 0.75; 95% confidence interval, 0.58 to 0.91, p=0.009, per 1-μg/mL increase). Adiponectin values at day 0 were positively associated with neurological severity as evaluated by the National Institute of Health Stroke Scale upon admission (r=0.420, p=0.003) and were higher in the groups with poor outcomes (modified Rankin Scale (mRS) ≥ 3 on day 90) than in those with good ones (mRS ≤ 2) in all stroke subtypes, with statistical significance in ATBI (p=0.015). CONCLUSIONS Plasma adiponectin values may help to classify stroke subtypes and predict neurological severity and functional outcome in ischemic stroke patients.
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Affiliation(s)
- Takahiro Kuwashiro
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Cerebrovascular Medicine and Neurology, Cerebrovascular Center and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka.
| | - Tetsuro Ago
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka.
| | - Masahiro Kamouchi
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Ryu Matsuo
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Jun Hata
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka; Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Junya Kuroda
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Kenji Fukuda
- Department of Cerebrovascular Disease, St. Mary's Hospital, Fukuoka
| | - Hiroshi Sugimori
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Masayo Fukuhara
- Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | | | | | | | - Masahiro Yasaka
- Department of Cerebrovascular Medicine and Neurology, Cerebrovascular Center and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka
| | - Yasushi Okada
- Department of Cerebrovascular Medicine and Neurology, Cerebrovascular Center and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka
| | - Yutaka Kiyohara
- Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
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Özcan KS, Güngör B, Altay S, Osmonov D, Ekmekçi A, Özpamuk F, Kemaloğlu T, Yıldırım A, Tayyareci G, Erdinler İ. Author's reply: To PMID 24268420. J Cardiol 2014; 64:420. [PMID: 24929621 DOI: 10.1016/j.jjcc.2014.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 04/30/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Kazım Serhan Özcan
- Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul 34087, Turkey
| | - Barış Güngör
- Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul 34087, Turkey.
| | - Servet Altay
- Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul 34087, Turkey
| | - Damirbek Osmonov
- Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul 34087, Turkey
| | - Ahmet Ekmekçi
- Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul 34087, Turkey
| | - Fatma Özpamuk
- Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul 34087, Turkey
| | - Tuğba Kemaloğlu
- Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul 34087, Turkey
| | - Aydın Yıldırım
- Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul 34087, Turkey
| | - Gülşah Tayyareci
- Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul 34087, Turkey
| | - İzzet Erdinler
- Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul 34087, Turkey
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17
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Herder C, Peltonen M, Svensson PA, Carstensen M, Jacobson P, Roden M, Sjöström L, Carlsson L. Adiponectin and bariatric surgery: associations with diabetes and cardiovascular disease in the Swedish Obese Subjects Study. Diabetes Care 2014; 37:1401-9. [PMID: 24574342 DOI: 10.2337/dc13-1362] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Adiponectin has been implicated in the pathogenesis of type 2 diabetes, but its role for incident diabetes, myocardial infarction, or stroke in obesity is unclear. The aim of this study was to analyze the associations between systemic levels of adiponectin and the aforementioned outcomes in a population with severe obesity at high risk of diabetes and cardiovascular events. RESEARCH DESIGN AND METHODS We measured serum concentrations of total adiponectin in 3,299 participants of the prospective controlled Swedish Obese Subjects (SOS) Study (bariatric surgery group, n = 1,570; control group given usual care, n = 1,729). Median follow-up periods ranged between 10 and 13 years for different outcomes. RESULTS In models containing both baseline adiponectin and 2-year changes in adiponectin, high baseline adiponectin and 2-year increases in adiponectin were associated with decreased risk of diabetes and myocardial infarction among controls. In the surgery group, the 2-year weight loss was paralleled by substantial increase in circulating adiponectin (1,807-1,958 ng/mL per 10-kg weight loss). However, neither baseline adiponectin nor 2-year increases in adiponectin were associated with risk of diabetes or myocardial infarction in the fully adjusted models in the surgery group. No associations were found for stroke in either group. CONCLUSIONS Taken together, baseline adiponectin and 2-year changes were associated with incident diabetes and myocardial infarction in the control group but not in the surgery group. Baseline adiponectin did not predict treatment benefit of bariatric surgery.
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Song J, Lee WT, Park KA, Lee JE. Association between risk factors for vascular dementia and adiponectin. BIOMED RESEARCH INTERNATIONAL 2014; 2014:261672. [PMID: 24860814 PMCID: PMC4016875 DOI: 10.1155/2014/261672] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 03/27/2014] [Accepted: 03/30/2014] [Indexed: 01/06/2023]
Abstract
Vascular dementia is caused by various factors, including increased age, diabetes, hypertension, atherosclerosis, and stroke. Adiponectin is an adipokine secreted by adipose tissue. Adiponectin is widely known as a regulating factor related to cardiovascular disease and diabetes. Adiponectin plasma levels decrease with age. Decreased adiponectin increases the risk of cardiovascular disease and diabetes. Adiponectin improves hypertension and atherosclerosis by acting as a vasodilator and antiatherogenic factor. Moreover, adiponectin is involved in cognitive dysfunction via modulation of insulin signal transduction in the brain. Case-control studies demonstrate the association between low adiponectin and increased risk of stroke, hypertension, and diabetes. This review summarizes the recent findings on the association between risk factors for vascular dementia and adiponectin. To emphasize this relationship, we will discuss the importance of research regarding the role of adiponectin in vascular dementia.
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Affiliation(s)
- Juhyun Song
- Department of Anatomy, Yonsei University College of Medicine, 50 Yonsei-ro, Seoul 120-752, Republic of Korea
| | - Won Taek Lee
- Department of Anatomy, Yonsei University College of Medicine, 50 Yonsei-ro, Seoul 120-752, Republic of Korea
| | - Kyung Ah Park
- Department of Anatomy, Yonsei University College of Medicine, 50 Yonsei-ro, Seoul 120-752, Republic of Korea
| | - Jong Eun Lee
- Department of Anatomy, Yonsei University College of Medicine, 50 Yonsei-ro, Seoul 120-752, Republic of Korea
- BK21 Plus Project for Medical Sciences and Brain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea
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19
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Ostan R, Bucci L, Cevenini E, Palmas MG, Pini E, Scurti M, Vescovini R, Caruso C, Mari D, Vitale G, Franceschi C, Monti D. Metabolic syndrome in the offspring of centenarians: focus on prevalence, components, and adipokines. AGE (DORDRECHT, NETHERLANDS) 2013; 35:1995-2007. [PMID: 23138631 PMCID: PMC3776117 DOI: 10.1007/s11357-012-9483-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 10/17/2012] [Indexed: 05/18/2023]
Abstract
With aging, an increased prevalence of a clustering of metabolic abnormalities has been observed. These abnormalities include obesity, dyslipidemia, hypertension, and insulin resistance and are collectively known as metabolic syndrome (MetS), a low-grade, systemic, inflammatory condition associated with an increased risk of cardiovascular disease, diabetes, and other adverse health outcomes. A number of studies have demonstrated that centenarians' offspring have a significant survival advantage and a lower risk of developing the most important age-related diseases. They therefore represent one of the best models with which to study the familiar component of human longevity. The aim of this study was to determine if the offspring of centenarians (n = 265 subjects) showed a different prevalence of MetS in comparison to the offspring of non-long-lived parents (controls, n = 101 subjects). In addition, we assessed whether centenarians' offspring showed particular features of MetS and a distinct regulation of circulating adipokines, cytokines, and metabolic mediators. Although the prevalence of MetS was quite similar both in the offspring of centenarians and the controls, MetS-affected centenarians' offspring seemed healthier, more functionally fit, and had lower resistin levels. MetS prevalence did not change in centenarians' offspring across resistin, IGF-1, and resistin/IGF-1 ratio tertiles. On the other hand, in controls, MetS prevalence strongly increased across resistin tertiles and in the third resistin/IGF-1 ratio tertile, indicating a dramatic increase in MetS prevalence when the ratio between these two factors is unbalanced, with high levels of resistin and low levels of IGF-1.
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Affiliation(s)
- R. Ostan
- />Department of Experimental Pathology, University of Bologna, Via San Giacomo, 12, 40126 Bologna, Italy
| | - L. Bucci
- />Department of Experimental Pathology, University of Bologna, Via San Giacomo, 12, 40126 Bologna, Italy
| | - E. Cevenini
- />Department of Experimental Pathology, University of Bologna, Via San Giacomo, 12, 40126 Bologna, Italy
| | - M. G. Palmas
- />Department of Experimental Pathology, University of Bologna, Via San Giacomo, 12, 40126 Bologna, Italy
| | - E. Pini
- />Department of Experimental Pathology, University of Bologna, Via San Giacomo, 12, 40126 Bologna, Italy
| | - M. Scurti
- />Department of Experimental Pathology, University of Bologna, Via San Giacomo, 12, 40126 Bologna, Italy
| | - R. Vescovini
- />Department of Internal Medicine and Biomedical Sciences, University of Parma, Via Gramsci, 14, 43126 Parma, Italy
| | - C. Caruso
- />Immunosenescence Unit, Department of Pathobiology and Biomedical Methodologies, University of Palermo, Corso Tukory, 211, 90100 Palermo, Italy
| | - D. Mari
- />Department of Medical Sciences, University of Milan, Via F. Sforza, 35, 20122 Milano, Italy
- />Geriatric Unit IRCCS Ca’ Granda Foundation Maggiore Policlinico Hospital, 20122 Milan, Italy
| | - G. Vitale
- />Department of Medical Sciences, University of Milan, Via F. Sforza, 35, 20122 Milano, Italy
- />IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - C. Franceschi
- />Department of Experimental Pathology, University of Bologna, Via San Giacomo, 12, 40126 Bologna, Italy
| | - D. Monti
- />Department of Experimental Pathology and Oncology, University of Florence, Viale Morgagni, 50, 50134 Florence, Italy
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Michalakis K, Goulis DG, Vazaiou A, Mintziori G, Polymeris A, Abrahamian-Michalakis A. Obesity in the ageing man. Metabolism 2013; 62:1341-9. [PMID: 23831443 DOI: 10.1016/j.metabol.2013.05.019] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 05/15/2013] [Accepted: 05/29/2013] [Indexed: 12/20/2022]
Abstract
As the population is ageing globally, both ageing and obesity are recognized as major public health challenges. The aim of this narrative review is to present and discuss the current evidence on the changes in body composition, energy balance and endocrine environment that occur in the ageing man. Obesity in the ageing man is related to changes in both body weight and composition due to alterations in energy intake and total energy expenditure. In addition, somatopenia (decreased GH secretion), late-onset hypogonadism (LOH), changes in thyroid and adrenal function, as well as changes in appetite-related peptides (leptin, ghrelin) and, most importantly, insulin action are related to obesity, abnormal energy balance, redistribution of the adipose tissue and sarcopenia (decreased muscle mass). A better understanding of the complex relationship of ageing-related endocrine changes and obesity could lead to more effective interventions for elderly men.
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Affiliation(s)
- K Michalakis
- First Department of Internal Medicine, National and Kapodestrian University of Athens, School of Medicine, "Laiko" General Hospital, Athens, Greece
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21
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Choe EY, Wang HJ, Kwon O, Kim KJ, Kim BS, Lee BW, Ahn CW, Cha BS, Lee HC, Kang ES, Mantzoros CS. Variants of the adiponectin gene and diabetic microvascular complications in patients with type 2 diabetes. Metabolism 2013; 62:677-85. [PMID: 23260797 DOI: 10.1016/j.metabol.2012.11.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 11/12/2012] [Accepted: 11/16/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of this study was to examine the association between common polymorphisms of the adiponectin gene (ADIPOQ) and microvascular complications in patients with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS Rs2241766 and rs1501299 of ADIPOQ were genotyped in 708 patients with T2DM. Fundus photography, nerve conducting velocity, and urine analysis were performed to check for the presence of microvascular complications including diabetic nephropathy, retinopathy and neuropathy. RESULTS The prevalence of diabetic nephropathy tended to be different according to rs2241766 genotype (p=0.057) and the GG genotype of rs2241766 was associated with diabetic nephropathy [urine albumin/creatinine ratio (UACR) greater than 30 mg/g] after adjusting for age, sex, body mass index, duration of diabetes, HDL-cholesterol, smoking status, and blood pressure (odds ratio=1.96; 95% confidence interval=1.01-3.82, p=0.049). Also, the G allele of rs2241766 demonstrated a trend to be associated with an increase in UACR (p=0.087). Rs2241766 genotype was not associated with diabetic retinopathy (p=0.955) and neuropathy (p=0.104) or any diabetic microvascular complications (p=0.104). There was no significant association between the rs1501299 genotype of ADIPOQ and the prevalence of diabetic retinopathy and neuropathy or any diabetic microvascular complications even after adjustment. CONCLUSION These data suggest that the GG genotype at rs2241766 is implicated in the pathogenesis of risk for diabetic nephropathy defined as UACR greater than 30 mg/day in patients with T2DM.
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Affiliation(s)
- Eun Yeong Choe
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, Korea
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Pezzini A, Grassi M, Paciaroni M, Zini A, Silvestrelli G, Iacoviello L, Di Castelnuovo A, Del Zotto E, Caso V, Nichelli PF, Giossi A, Volonghi I, Simone AM, Lanari A, Costa P, Poli L, Pentore R, Falzone F, Gamba M, Morotti A, Ciccone A, Ritelli M, Guido D, Colombi M, De Gaetano G, Agnelli G, Padovani A. Obesity and the risk of intracerebral hemorrhage: the multicenter study on cerebral hemorrhage in Italy. Stroke 2013; 44:1584-9. [PMID: 23549133 DOI: 10.1161/strokeaha.111.000069] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE The effect of obesity on the risk of intracerebral hemorrhage (ICH) may depend on the pathophysiology of vessel damage. To further address this issue, we investigated and quantified the correlations between obesity and obesity-related conditions in the causal pathways leading to ICH. METHODS A total of 777 ICH cases ≥ 55 years of age (287 lobar ICH and 490 deep ICH) were consecutively enrolled as part of the Multicenter Study on Cerebral Hemorrhage in Italy and compared with 2083 control subjects by a multivariate path analysis model. Separate analyses were conducted for deep and lobar ICH. RESULTS Obesity was not independently associated with an increased risk of lobar ICH (odds ratio [OR], 0.76; 95% confidence interval [CI], 0.58-1.01) or deep ICH (OR, 1.18; 95% CI, 0.95-1.45) when compared with control subjects. The path analysis confirmed the nonsignificant total effect of obesity on the risk of lobar ICH (OR, 0.77; 95% CI, 0.58-1.02) but demonstrated a significant indirect effect on the risk of deep ICH (OR, 1.28; 95% CI, 1.03-1.57), mostly determined by hypertension (OR, 1.07; 95% CI, 1.04-1.11) and diabetes mellitus (OR, 1.04; 95% CI, 1.01-1.07). Obesity was also associated with an increased risk of deep ICH when compared with lobar ICH (OR, 1.62; 95% CI, 1.14-2.31). CONCLUSIONS Obesity increases the risk of deep ICH, mostly through an indirect effect on hypertension and other intermediate obesity-related comorbidities, but has no major influence on the risk of lobar ICH. This supports the hypothesis of different, vessel-specific, biological mechanisms underlying the relationship between obesity and cerebral hemorrhage.
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Affiliation(s)
- Alessandro Pezzini
- Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, P.le Spedali Civili 1, 25123 Brescia, Italia.
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Michalakis K, Mintziori G, Kaprara A, Tarlatzis BC, Goulis DG. The complex interaction between obesity, metabolic syndrome and reproductive axis: a narrative review. Metabolism 2013; 62:457-78. [PMID: 22999785 DOI: 10.1016/j.metabol.2012.08.012] [Citation(s) in RCA: 199] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 08/13/2012] [Accepted: 08/18/2012] [Indexed: 12/16/2022]
Abstract
The aim of this narrative review is to provide current evidence for the interaction between obesity, metabolic syndrome (MS) and reproductive axis. Gonadotropin-releasing hormone (GnRH) pulses and, consequently, normal function of reproductive (hypothalamus-pituitary-gonadal) axis depend on normal energy balance, which presupposes sufficient food intake, reasonable energy consumption and average thermoregulatory costs. In case of an energy imbalance, reproductive dysfunction may occur. In young women, excessive leanness is accompanied by puberty delay, whereas premature puberty might be a manifestation of obesity. In a similar way, obesity in men affects fertility. Excess adipose tissue results in increased conversion of testosterone to estradiol, which may lead to secondary hypogonadism through reproductive axis suppression. Moreover, oxidative stress at the level of the testicular micro-environment may result in decreased spermatogenesis and sperm damage. Products of the adipocyte, such as leptin, adiponectin and resistin, and gut peptides, such as ghrelin, are considered to be crucial in the interaction between energy balance and reproduction. Finally, an indirect evidence for the interplay between MS and reproductive axis is the fact that when treating components of one, parameters of the other can be improved as well. These therapeutic interventions include lifestyle modifications, pharmacological agents, such as sex hormone replacement therapy, and surgical procedures. Although many issues remain unclear, the elucidation of the complex interaction between MS and reproductive axis will have obvious clinical implications in the therapeutic approach of both entities.
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Affiliation(s)
- Konstantinos Michalakis
- First Department of Internal Medicine, Laikon University Hospital, Athens University Medical School, Greece
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Wannamethee SG, Shaper AG, Whincup PH, Lennon L, Sattar N. Adiposity, adipokines, and risk of incident stroke in older men. Stroke 2012. [PMID: 23192755 DOI: 10.1161/strokeaha.112.670331] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The association between adiposity and adipocytes and risk of stroke in older adults is uncertain. We have examined the association between adiposity measures and adipocytes (adiponectin and leptin) with incident stroke events in older men. METHODS Prospective study of 3411 men aged 60 to 79 years with no previous diagnosis of myocardial infarction, heart failure, or stroke followed-up for an average of 9 years, during which there were 192 incident major stroke events. RESULTS In age-adjusted analyses, body mass index and waist circumference were not significantly associated with risk of stroke in older men, although obese men (body mass index >30 kg/m(2)) showed the lowest risk of stroke. Despite the strong positive correlation between leptin and body mass index and waist circumference, risk of stroke was significantly increased in those in the top quartile of the leptin distribution. The increased risk remained after adjustment for potential confounders, including systolic blood pressure (adjusted hazard ratios top quartile versus bottom quartile: 2.03; confidence interval, 1.27-3.27]). Further adjustment for markers of inflammation (c-reactive protein), endothelial dysfunction (von Willebrand factor), fibrinolytic activity (d-dimer), and γ-glutamyl transferase attenuated the increased risk, but risk remained significantly increased (adjusted hazard ratios, 1.73; confidence interval, 1.06-2.83]). By contrast, no association was seen between adiponectin and risk of stroke. CONCLUSIONS Conventional adiposity measures were not associated with increased stroke risk in older men. However, leptin (a good marker of percent fat mass), but not adiponectin, predicted stroke, suggesting a link between fat mass and stroke risk.
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Affiliation(s)
- S Goya Wannamethee
- Department of Primary Care and Population Health, UCL Medical School, Royal Free Campus, Rowland Hill St, London NW32PF, UK.
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Gonzalez NR, Liebeskind DS, Dusick JR, Mayor F, Saver J. Intracranial arterial stenoses: current viewpoints, novel approaches, and surgical perspectives. Neurosurg Rev 2012; 36:175-84; discussion 184-5. [PMID: 23097149 DOI: 10.1007/s10143-012-0432-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 06/18/2012] [Accepted: 07/15/2012] [Indexed: 10/27/2022]
Abstract
Ten percent of all strokes occurring in the USA are caused by intracranial arterial stenosis (IAS). Symptomatic IAS carries one of the highest rates of recurrent stroke despite intensive medical therapy (25 % in high-risk groups). Clinical results for endovascular angioplasty and stenting have been disappointing. The objectives of this study were to review the contemporary understanding of symptomatic IAS and present potential alternative treatments to resolve factors not addressed by current therapies. We performed a literature review on IAS pathophysiology, natural history, and current treatment. We present an evaluation of the currently deficient aspects in its treatment and explore the role of alternative surgical approaches. There is a well-documented interrelation between hemodynamic and embolic factors in cerebral ischemia caused by IAS. Despite the effectiveness of medical therapy, hemodynamic factors are not addressed satisfactorily by medications alone. Collateral circulation and severity of stenosis are the strongest predictors of risk for stroke and death. Indirect revascularization techniques, such as encephaloduroarteriosynangiosis, offer an alternative treatment to enhance collateral circulation while minimizing risk of hemorrhage associated with hyperemia and endovascular manipulation, with promising results in preliminary studies on chronic cerebrovascular occlusive disease. Despite improvements in medical management for IAS, relevant aspects of its pathophysiology are not resolved by medical treatment alone, such as poor collateral circulation. Surgical indirect revascularization can improve collateral circulation and play a role in the treatment of this condition. Further formal evaluation of indirect revascularization for IAS is a logical and worthy step in the development of intracranial atherosclerosis treatment strategies.
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Affiliation(s)
- Nestor R Gonzalez
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, 10833 LeConte Ave., Rm 18-251 Semel, Los Angeles, CA 90095-7039, USA.
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