Relationship of Plasma Adiponectin and Waist-hip Ratio with Coronary Artery Disease

Correlation Analysis and Diagnostic Value of Serum Homocysteine, Cystatin C and Uric Acid Levels with the Severity of Coronary Artery Stenosis in Patients with Coronary Heart Disease

Background

Coronary angiography (CAG) is an invasive examination with high risks and costs and various complications may occur. It is necessary to find a diagnostic method, non-invasiveness, inexpensive with low risk. This study aims to analyze the correlation between the levels of serum homocysteine (Hcy), cystatin C (Cys C) and uric acid (UA) and Gensini score in patients with coronary heart disease (CHD) and assess their diagnostic value for CHD.

Methods

A retrospective analysis was conducted on 1412 patients underwent CAG from October 2019 to December 2021, and we conducted this study from January to July 2022. A total of 765 patients with CHD confirmed by CAG were selected as the research group, while 647 patients revealed as non-obstructive stenosis by CAG as the control group. The serum Hcy, Cys C and UA levels were detected and the correlation between Gensini score and variables was analyzed. The receiver-operating characteristic (ROC) curve was performed to assess the diagnostic value of the Hcy, Cys C and UA for CHD.

Results

The serum Hcy, Cys C and UA levels in the research group were higher as compared with the control group (p<0.05). Spearman correlation and multivariate linear regression analysis showed that there was a significantly positive correlation between Gensini score and serum Hcy, Cys C and UA levels (p<0.05). The ROC curve analysis presented the combined Hcy and Cys C with UA having the highest specificity of diagnostic value for CHD (area under the curve (AUC)=0.768, 95% CI 0.706-0.823, specificity = 72.34%, sensitivity = 67.88%, Youden Index = 0.4022).

Conclusion

The serum Hcy, Cys C and UA levels in patients with CHD were significantly increased, positive correlation with Gensini score. The combined Hcy and Cys C with UA could be used to assess the severity of coronary artery stenosis and provide predictive and early intervention treatment values for CHD and a new way of diagnosing CHD, which is cheap, safe, effective and deserving of clinical application.

Serum levels of adiponectin, resistin and tumour necrosis factor-alpha in Nigerian men with nuchal fat fold

BACKGROUND

Factors necessitating the propensity of adults with upper body fat deposition (UBFD) for developing insulin resistance and cardiovascular diseases (CVDs) are poorly understood. Therefore, understanding the roles of adipocytokines in the development of UBFD-associated pathologies could be of clinical importance.

AIM

To assess the levels of selected adipocytokines in males with nuchal fat fold (NFF).

METHODOLOGY

Eighty-six males (43 with NFF and 43 without NFF) were enrolled into this study. Serum levels of tumour necrosis factor-alpha (TNF-α), resistin and adiponectin were determined using ELISA.

RESULTS

Adiponectin level was significantly higher while resistin and TNF-α levels were significantly lower in NFF compared with the controls. TNF-α had significant positive correlation with systolic blood pressure (SBP) while adiponectin had significant positive correlation with the waist-hip ratio (WHR). Stratifying based on the obesity status, the mean body weight, BMI, waist circumference (WC), hip circumference (HC), WHR, neck circumference (NC), NFF and diastolic BP were significantly higher in NFF with obesity compared with those without obesity. However, levels of TNF-α, resistin and adiponectin were similar between the two groups.

CONCLUSIONS

NFF is associated with elevation in adiponectin level and increased CVD risk. NFF can therefore, serve as an index of early onset of cardiometabolic diseases.

Discriminatory Capacity of Anthropometric Indices for Cardiovascular Disease in Adults: A Systematic Review and Meta-Analysis

INTRODUCTION

Obesity is one of the main risk factors for cardiovascular disease (CVD) and cardiometabolic disease (CMD). Many studies have developed cutoff points of anthropometric indices for predicting these diseases. The aim of this systematic review was to differentiate the screening potential of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) for adult CVD risk.

METHODS

We used relevant key words to search electronic databases to identify studies published up to 2019 that used receiver operating characteristic (ROC) curves for assessing the cut-off points of anthropometric indices. We used a random-effects model to pool study results and assessed between-study heterogeneity by using the I² statistic and Cochran's Q test.

RESULTS

This meta-analysis included 38 cross-sectional and 2 cohort studies with 105 to 137,256 participants aged 18 or older. The pooled area under the ROC curve (AUC) value for BMI was 0.66 (95% CI, 0.63-0.69) in both men and women. The pooled AUC values for WC were 0.69 (95% CI, 0.67-0.70) in men and 0.69 (95% CI, 0.64-0.74) in women, and the pooled AUC values for WHR were 0.69 (95% CI, 0.66-0.73) in men and 0.71 (95% CI, 0.68-0.73) in women.

CONCLUSION

Our findings indicated a slight difference between AUC values of these anthropometric indices. However, indices of abdominal obesity, especially WHR, can better predict CVD occurrence.

The effect of crocetin supplementation on markers of atherogenic risk in patients with coronary artery disease: a pilot, randomized, double-blind, placebo-controlled clinical trial

BACKGROUND AND PURPOSE

Molecular mechanisms of atherogenesis are considered to be emerging therapeutic targets for atherosclerosis prevention. Cell and animal studies have shown that crocetin can decelerate atherogenesis. However, the anti-atherogenic properties of crocetin in humans are still ambiguous.

METHODS AND RESULTS

Fifty clinically diagnosed CAD patients were randomly divided into two parallel groups, crocetin and placebo, who received one capsule of crocetin (10 mg) and placebo per day, respectively, for two months. Serum circulating homocysteine (Hcy) [-1.09 (-1.64 to -0.54) μM, P = 0.001], heart-type fatty acid binding protein (h-FABP) [-2.07 (-2.72 to -1.43) ng mL^-1, P = 0.001], intercellular adhesion molecule 1 [-14.92 (-21.92 to -7.92) ng mL^-1, P = 0.001], vascular cell adhesion molecule 1 [-18.61 (-29.73 to -7.49) ng mL^-1, P = 0.002], and monocyte chemoattractant protein 1 [-4.67 (-6.50 to -2.83) pg mL^-1, P = 0.001] decreased significantly after the trial in the crocetin group, while high-density lipoprotein (HDL) significantly increased [+4.21 (0.68 to 7.73) mg mL^-1, P = 0.021]. Also, systolic [-0.21 (-0.32 to -0.10) mmHg, P = 0.001] and diastolic [-0.20 (-0.34 to -0.07) mmHg, P = 0.004] blood pressures decreased significantly in the crocetin group. Nevertheless, clinically significant percentage changes were only observed in Hcy (-15.25 ± 3.15, μM), HDL (-10.70 ± 5.06, mg dL^-1), and h-FABP (-21.10 ± 3.09, ng mL^-1) in the crocetin group. Furthermore, the relative increase in the gene expressions of sirtuin1 and AMP-activated protein kinase and a decrease in the lectin-type oxidized LDL receptor 1 and nuclear factor-kappa B expression in isolated peripheral blood mononuclear cells in the crocetin group were significant at the end of the trial in comparison with the placebo.

CONCLUSION

As the first human study, we showed the ability of crocetin to alter the expression of atherogenic genes and endothelial cell adhesion molecules in CAD patients. It appears that crocetin could be considered as a promising anti-atherogenic candidate for future studies.

Genetically driven adiposity traits increase the risk of coronary artery disease independent of blood pressure, dyslipidaemia, glycaemic traits

Adiposity has been associated with the risk of coronary artery disease (CAD) in observational studies, but their association may differ according to specific characteristics of studies. In Mendelian randomization (MR) analyses, genetic variants are used as instrumental variables (IVs) of exposures to examine causal effects to overcome confounding factors and reverse causation. We performed MR analyses for adiposity (n = 322,154) on risk of CAD (60,801 cases and 123,504 controls) based on the currently largest genome-wide association studies. The estimated associations between adiposity traits and CAD were calculated by an inverse-variance weighted method with and without excluding the IVs, which are associated with the well-known risk factors of CAD. Genetic variants are identified to be associated with the well-known risk factors of CAD by a cross-phenotype meta-analysis method. Our results furnished strong evidence for a causal role of adiposity in risk of CAD, with the odds ratios (ORs) for CAD being 1.53 (95% CI 1.36-1.72) for body mass index (BMI), 1.48 (1.20-1.96) for waist-hip ratio (WHR), and 1.34 (1.07-1.59) for WHR adjusted for BMI (WHRadjBMI), respectively. After excluding mediators-associated IVs from the MR analyses, the corresponding ORs were 1.46 (1.28-1.67) for BMI, 1.39 (1.01-1.93) for WHR, and 1.38 (1.04-1.84) for WHRadjBMI, respectively. Furthermore, our results suggested that central adiposity and general adiposity might pose a similar risk for CAD. In summary, our data supported that genetically driven adiposity traits imposed the risk of CAD independent of blood pressure, dyslipidaemia, glycaemic traits, and type 2 diabetes.

Saffron and crocin improved appetite, dietary intakes and body composition in patients with coronary artery disease

Introduction: Central obesity is an independent risk factor for coronary artery disease (CAD). It can increase cardio-metabolic risks through hypertension, hyperlipidemia and insulin resistance. Saffron and its bioactive compounds (crocin and crocetin) can modify some of metabolic disorders through multiple mechanisms. The aim of this study was to assess the efficacy of saffron and crocin on lipid profile, appetite, dietary intakes, anthropometric indices and body composition in patients with CAD. Methods: This 8 weeks randomized, double-blind, and placebo-controlled trial was conducted on 84 patients with CAD between the ages of 40 and 65 years old. Participants were randomly divided into groups to receive a daily supplement of 30 mg saffron aqueous extract (SAE) or 30 mg crocin or placebo. Appetite, dietary intake, anthropometry, body composition, biochemical analysis were assessed before and after the study. Results: In SAE and crocin group, anthropometric and some body composition variables revealed a pattern of improvement after intervention. Decrease in body mass index (BMI), waist circumference and fat mass values in SAE group was significantly more than crocin group (P < 0.001). There was no significant difference at the end of study in lipid profile parameters. Both SAE and crocin yielded significant decrease in energy and dietary intake mean values (P < 0.001 and P = 0.046), while it remained unchanged in the placebo group, also the appetite decreased significantly in SAE and crocin group (P < 0.001 and P = 0.029, respectively). Conclusion: The results of present study regarding anti-obesity feature of SAE and crocin in patients with CAD was promising. However the SAE was better in appetite suppressing, dietary intake and central obesity reduction.