Correlation of Serum Adipolin with Epicardial Fat Thickness and Severity of Coronary Artery Diseases in Acute Myocardial Infarction and Stable Angina Pectoris Patients

Negative association of apelin plasma levels with epicardial fat thickness in patients with stable angina and acute myocardial infarction: A case-control study

Background

Apelin is one of the endogenous peptides that play a key role in the homeostasis of cardiovascular diseases. The purpose of the current study was to evaluate the correlation between apelin levels and epicardial fat thickness (EFT) in patients with stable angina and acute myocardial infarction (AMI).

Materials and Methods

In a case-control study, 90 patients nominated for angiography were enrolled in the study and divided into three groups: healthy subjects without angiographic findings (Con), stable angina pectoris group (SAP), and acute AMI group. Data collected from all subjects included biochemical, echocardiographic, and angiographical parameters. The Gensini score analyzed the severity of coronary artery disease (CAD).

Results

A decrease in adjusted apelin levels was evident in the AMI and SAP groups compared with healthy individuals (for both P < 0.001), especially in the AMI group. In addition, a detectable negative association was identified between apelin and Gensini score (r = -0.288, P = 0.006), Ck-MB (r = -0.300, P = 0.004), EFT (r = -0.300, P = 0.004), and troponin-T (r = -0.288, P = 0.006).

Conclusion

Myocardial injury in patients with CAD appears to play a significant role in apelin concentration independent of the role of adipose tissue, which requires further studies.

Protective effects of 4-methylumbelliferone on myocardial ischemia/reperfusion injury in rats through inhibition of oxidative stress and downregulation of TLR4/NF-κB/NLRP3 signaling pathway

Myocardial ischemia-reperfusion injury (MI/R) has been found to be one of the important risk factors for global cardiac mortality and morbidity. The study was conducted to inquire into the protective effect of 4-methylumbilliferon (4-MU) against MI/R in rats and clarify its potential underlying mechanism. Animals were divided into four groups (n = 15) including sham, MI/R, MI/R + vehicle, and MI/R + 4-MU. MI/R was established in Wistar rats by occluding the left anterior descending (LAD) coronary artery for 30 min. 4-MU (25 mg/kg) was injected intraperitoneally before the induction of reperfusion. Cardiac function, fibrosis, oxidant/antioxidant markers, and inflammatory cytokines were evaluated using echocardiography, ELISA, and Western blot assay. As a result of MI/R induction, a decrease in left ventricular contractile function occurred along with increased cardiac fibrosis and tissue damage. The serum levels of TNF-α, IL-1β, and IL-18 increased, while IL-10 decreased. Oxidant/antioxidant changes were evident with increased MDA levels and decreased GSH, SOD, and CAT in the MI/R group. Furthermore, the protein levels of TLR4, NF-κB, and NLRP3 were significantly increased in the heart tissue of MI/R group. Treatment with 4-MU significantly prevented the reduction of cardiac contractile function and its pathological changes as a result of MI/R by inhibiting the increase of serum inflammatory factors and improving the oxidant/antioxidant balance probably through the TLR4/NF-κB/NLRP3 axis. The results of a current study showed that 4-MU had a potential ability to attenuate the cardiac injury by reducing oxidative stress and inflammation in a TLR4/NF-κB/NLRP3-dependent mechanism.

Role of Lipid Profile and Its Relative Ratios (Cholesterol/HDL-C, Triglyceride/HDL-C, LDL-C/HDL-C, WBC/HDL-C, and FBG/HDL-C) on Admission Predicts In-Hospital Mortality COVID-19

Background

Lipid profile and its related ratios such as total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), TG/HDL-C ratio, TC/HDL-C ratio, LDL-C/HDL-C ratio, white blood cell (WBC)/HDL-C ratio, and fasting blood glucose (FBG)/HDL-C ratio are valuable indicators that have been studied in various disorders to predict mortality. The present study was conducted with the aim of investigating the role of lipid profile ratios in predicting mortality in COVID-19 patients.

Methods

At the beginning of hospitalization, laboratory tests were taken from all patients (n = 300). The ability of lipid profile ratios to determine the COVID-19 severity was evaluated using receiver-operating characteristic (ROC). In addition, survival probability was determined with the average of Kaplan-Meier curves, so that the end point was death.

Results

In deceased patients, TG, TC, LDL-C, HDL-C, TC/HDL-C, TG/HDL-C, and LDL-C/HDL-C parameters were significantly lower than those of surviving patients, while WBC/HDL-C and FBG/HDL-C were significantly higher. TC (HR = 3.178, 95%CI = 1.064 to 9.491, P < 0.05), TG (HR = 3.276, 95%CI = 1.111 to 9.655, P < 0.05), LDL-C (HR = 3.207, 95%CI = 1.104 to 9.316, P < 0.05), and HDL-C (HR = 3.690, 95%CI = 1.290 to 10.554, P < 0.05), as well as TC/HDL-C (HR = 3.860, 95%CI = 1.289 to 11.558, P < 0.05), TG/HDL-C (HR = 3.860, 95%CI = 1.289 to 11.558, P < 0.05), LDL-C/HDL-C (HR = 3.915, 95%CI = 1.305 to 11.739, P < 0.05), WBC/HDL-C (HR = 3.232, 95%CI = 1.176 to 8.885, P < 0.05), and FBG/HDL-C ratios (HR = 4.474, 95%CI = 1.567 to 12.777, P < 0.01), were detectably related to survival. The multivariate Cox regression models showed that only FBG/HDL-C ratio (HR = 5.477, 95%CI = 1.488 to 20.153, P < 0.01) was significantly related to survival.

Conclusion

The results suggested that FBG/HDL-C ratio in hospital-admitted COVID-19 patients was a reliable predictor of mortality.

Adipolin and IL-6 Serum Levels in Chronic Obstructive Pulmonary Disease

Objective(s): One of the adipokines that have insulin-sensitizing properties is adipolin, whose reduced levels have been reported in obesity, oxidative stress, and inflammation. The present study investigated serum interleukin-6 (IL-6) and adipolin levels in chronic obstructive pulmonary disease (COPD) patients. Method: A control case study included 60 COPD patients and 30 healthy subjects in the research and measured adipolin and IL-6 serum levels. In addition, serum adipolin levels in COPD patients were assessed according to the GOLD grade. The relationship between serum adipolin levels and study variables were also analyzed. Results: The results showed reduced adipolin levels in COPD patients compared with healthy individuals (p < 0.001). Furthermore, increased levels of IL-6 were evident in the COPD group compared to the control group (p < 0.001). Adipolin serum levels were positively correlated with PFTs and negatively correlated with IL-6 levels. Conclusion: Decreased adipolin levels enhanced disease severity in COPD patients. It seems that the existence of a significant relationship between adipolin and IL-6 may indicate the role of adipolin in the pathophysiology of COPD.

Association of plasma visfatin with epicardial fat thickness and severity of coronary artery diseases in patients with acute myocardial infarction and stable angina pectoris

BACKGROUND

Elevated serum visfatin levels have been reported in some chronic inflammatory diseases such as cardiovascular diseases (CVDs) and rheumatoid arthritis. The purpose of the present study was to investigate the correlation between visfatin and interleukin-6 (IL-6) and anthropometric, angiographic, echocardiographic, and biochemical parameters in patients with acute myocardial infarction (AMI).

METHODS

In this case-control study, 90 patients who were candidates for angiography were divided into the following 3 groups: non-coronary artery disease group (non-CAD; n = 30) with a history of chest pain without angiographic changes, stable angina pectoris group (SAP; n = 30), and AMI group (n = 30). Anthropometric, angiographic, echocardiographic, and biochemical parameters were measured in all subjects.

RESULTS

The mean age of patients in the non-CAD, SAP, and AMI groups was 62.26 ± 13.24, 62.93 ± 8.35, and 52.83 ± 10.26 years (P < 0.001) respectively. The results showed that the median [interquartile range] of visfatin level was higher in the AMI group [7 (6.30-9.30), pg/ml] compared with the SAP [5.85 (5.20-6.60); P < 0.001] and non-CAD [5.20 (3.30-5.70); P < 0.001] groups. In addition, median [interquartile range] IL-6 levels were higher in the AMI group [17.5 (16-21), pg/ml] compared with the SAP [15.50 (14-18); P < 0.01] and non-CAD [14 (11-17); P < 0.001] groups. Furthermore, there was a positive association between plasma level of visfatin, and epicardial fat thickness (EFT) and the Gensini score in the SAP and AMI patients. The results of multivariate linear regression analysis revealed that white blood cell ý(WBC) count and IL-6 were independently associated with plasma visfatin level.

CONCLUSION

The current study showed an association between visfatin and EFT in AMI patients. Increased visfatin levels in patients with AMI may contribute to atherosclerosis; however, further studies should be conducted to confirm this finding.

Adipose Tissue Immunomodulation: A Novel Therapeutic Approach in Cardiovascular and Metabolic Diseases

Adipose tissue is a critical regulator of systemic metabolism and bodily homeostasis as it secretes a myriad of adipokines, including inflammatory and anti-inflammatory cytokines. As the main storage pool of lipids, subcutaneous and visceral adipose tissues undergo marked hypertrophy and hyperplasia in response to nutritional excess leading to hypoxia, adipokine dysregulation, and subsequent low-grade inflammation that is characterized by increased infiltration and activation of innate and adaptive immune cells. The specific localization, physiology, susceptibility to inflammation and the heterogeneity of the inflammatory cell population of each adipose depot are unique and thus dictate the possible complications of adipose tissue chronic inflammation. Several lines of evidence link visceral and particularly perivascular, pericardial, and perirenal adipose tissue inflammation to the development of metabolic syndrome, insulin resistance, type 2 diabetes and cardiovascular diseases. In addition to the implication of the immune system in the regulation of adipose tissue function, adipose tissue immune components are pivotal in detrimental or otherwise favorable adipose tissue remodeling and thermogenesis. Adipose tissue resident and infiltrating immune cells undergo metabolic and morphological adaptation based on the systemic energy status and thus a better comprehension of the metabolic regulation of immune cells in adipose tissues is pivotal to address complications of chronic adipose tissue inflammation. In this review, we discuss the role of adipose innate and adaptive immune cells across various physiological and pathophysiological states that pertain to the development or progression of cardiovascular diseases associated with metabolic disorders. Understanding such mechanisms allows for the exploitation of the adipose tissue-immune system crosstalk, exploring how the adipose immune system might be targeted as a strategy to treat cardiovascular derangements associated with metabolic dysfunctions.