Serum resistin levels and cardiovascular events in patients undergoing percutaneous coronary intervention

Differential prognostic value of resistin for cardiac death in patients with coronary artery disease according to the presence of metabolic syndrome

Resistin is associated with atherosclerosis progression by affecting inflammation and insulin resistance. There are controversial data regarding the prognostic value of resistin in stable coronary artery disease (CAD) patients. We prospectively investigated the long-term prognostic value of resistin in patients with stable CAD. A total 741 consecutive patients with stable CAD were followed for a median of 5.5 years. Serum resistin, lipids, high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6) levels were measured at baseline. Primary endpoints were cardiac death and secondary hospitalizations for acute coronary syndrome, arrhythmic event or ischemic stroke. Follow-up data were obtained from 703 patients of whom 79 had a cardiac death (11.2%) and 205 (29.2%) met the secondary endpoints. Resistin was positively correlated with hsCRP (r = 0.159, p < 0.001) and IL-6 (r = 0.165, p = 0.002), and negatively with high-density lipoprotein-cholesterol (r = - 0.176, p < 0.001). Resistin levels could not predict cardiac death [HR 1.044; 95% CI 0.994-1.096; p = 0.087] neither secondary endpoints [HR 1.025; 95% CI 0.983-1.068; p = 0.250). Among 298 patients (42.4%) with metabolic syndrome (MS) resistin levels were independently associated with cardiac death after adjustment for conventional risk factors [HR 1.121; 95% CI 1.045-1.204; p = 0.002). Further adjustment for ejection fraction of left ventricle (LVEF) did not change the association (HR 1.145; 95% CI 1.057-1.240; p = 0.001). Patients with resistin values ≥ 7.6 ng/mL (median level) had 2.8 times higher risk of cardiac death compared to those with resistin levels < 7.6 ng/mL after adjustment for traditional risk factors and LVEF (HR 2.882; 95% CI 1.311-6.336; p = 0.008). Resistin is independently associated with cardiac death in patients with stable CAD and MS.

Is resistin the master link between inflammation and inflammation-related chronic diseases?

Resistin has been firstly discovered in mice and was identified as an adipose tissue-secreted hormone or adipokine linking obesity and insulin resistance. In humans, resistin has been characterized as a hormone expressed and secreted by Immune cells especially by macrophages, and was linked to many inflammatory responses including inflammation of adipose tissue due to macrophages' infiltration. Human and mouse resistin display sequence and structural similarities and also dissimilarities that could explain their different expression pattern. In mice, strong pieces of evidence clearly associated high resistin plasma levels to obesity and insulin resistance suggesting that resistin could play an important role in the onset and progression of obesity and insulin resistance via resistin-induced inflammation. In humans, the link between resistin and obesity/insulin resistance is still a matter of debate and needs more epidemiological studies. Also, resistin has been linked to other chronic diseases such as cardiovascular diseases and cancers where resistin has been proposed in many studies as a biological marker.

Exercise and apulian hypocaloric diet affect adipokine changes and gastric banding-induced weight loss: A prospective study on severe obese subjects

Background

Adiponectin and Resistin correlate with insulin sensitivity and cardiovascular risk, respectively. This study aimed to identify lifestyle factors that modulate changes in Adiponectin and Resistin levels after gastric banding positioning (LapGB).

Materials and methods

Before (T0), 3 months (T3), 6 months (T6), and 12 months (T12) after LapGB, serum Adiponectin and Resistin levels were evaluated in a single-centre prospective study including a cohort of 27 non-diabetic obese subjects (S-Ob, BMI ≥35 kg/m²). After surgery, a dietitian checked the adherence of S-Ob to an Apulian hypocaloric diet (aphypoD)/physical activity (phA) and, according to their high or low compliance to aphypoD/phA, S-Ob were included in group 1 (n = 14) or 2 (n = 13) respectively. Serum Adiponectin and Resistin were also measured in 10 healthy controls.

Results

At baseline, Resistin levels were significantly higher and Adiponectin levels significantly lower in S-Ob than in controls. After surgery, group 1 showed a 50.2% excess weight loss (%EWL), significantly decreased Resistin levels at T12 and increased Adiponectin levels at both T6 and T12 as compared with baseline. Group 2 showed 24.6 %EWL at T12, decreased Adiponectin levels at T6 and T12 as compared with baseline, but unaltered Resistin levels. After surgery, group 1 followed aphypoD/phA, while group 2 did not.

Conclusions

LapGB fails to improve cardiovascular risk markers (Resistin) in S-Ob not improving lifestyle. Future studies might investigate these findings in a larger cohort and display whether aphypoD is more effective than other dietary intervention on cardiovascular risk in subjects undergoing LapGB or other Bariatric procedures.

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Gastric banding (LapGB) plus a 12-month lifestyle program was followed by a % excess weight loss >40.

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Resistin significantly declined in subjects adhering to a 1-year LapGB/lifestyle intervention.

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In subjects not following any lifestyle program after surgery, Adiponectin unexpectedly decreased.

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LapGB fails to change cardiovascular risk or insulin sensitivity without a healthy lifestyle.

Relationship between Resistin, Endothelin-1, and Flow-Mediated Dilation in Patient with and without Metabolic Syndrome

Background:

Resistin is peptides that signal the functional status of adipose tissue to the brain and other target organs. It causes insulin resistance and affects the vascular endothelial dysfunction. However, the function and relation between resistin in endothelin-1 (ET-1), which leads to the endothelial dysfunction in humans are enigmatic.

Materials and Methods:

In a cross-sectional study of 76 participants (38 metabolic syndrome patients and 38 healthy participants), biochemical and clinical parameters, including lipid profile, fasting glucose, resistin, ET-1, C-reactive protein (CRP), flow-mediated dilation (FMD), and hypertension were determined and compared between the two groups.

Results:

Multiple linear regression analysis was performed with age- and sex-adjusted plasma resistin levels, FMD, and ET-1 as the dependent variables. Analysis showed that weight, body mass index, triglycerides (TGs), and ET-1 were statistically significant correlated with serum resistin. FMD has negative significantly correlated with weight (r = −0.491, P = 0.001), waist circumference (r = −0.491, P = 0.001), waist-to-hip ratio (r = −0.0444, P = 0.001), and ET-1 (r = −0.075, P = 0.050), but it has significantly correlated with systolic blood pressure (SBP) (r = 0.290, P = 0.016), diastolic blood pressure (DBP) (r = 0.275, P = 0.023), and high-density lipoprotein cholesterol (HDL-C) (r = −0.266, P = 0.050), and ET-1, but it has significantly correlated with SBP, DBP, and HDL-C. ET-1 is significantly correlated with TGs (r = −0.436, P = 0.006), total cholesterol (r = 0.452, P = 0.004), low-density lipoprotein cholesterol (r = 0.454, r = 0.004), and resistin (r = 0.282, P = 0.050), whereas it has negative significantly correlated with HDL-C (r = 0.346, P = 0.034), FMD (r = −0.075, P = 0.050.

Conclusion:

In this study, results shown plasma ET-1 and resistin are suggested as risk factors for the development of endothelial dysfunction and with further study, it is possible that can diagnose the risk of diabetes and cardiovascular disease in the early stages.

Serum resistin is associated with impaired endothelial function and a higher rate of adverse cardiac events in patients with peripheral artery disease

OBJECTIVE

Resistin is a hormone that has been associated with metabolic syndrome and cardiovascular disease. The role of resistin in patients with peripheral artery disease (PAD) has not been fully explored. This study seeks to understand the relationship between serum resistin, vascular function, and cardiovascular outcomes in patients with PAD.

METHODS

There were 106 patients with PAD who were recruited between 2011 and 2016. Patients attended a baseline visit during which a comprehensive vascular physiology assessment including medical and surgical history, radial artery tonometry, and flow mediated-vasodilation (FMD) was completed. A blood sample was drawn, and serum resistin was assayed using enzyme-linked immunosorbent assay kits. Using the time of study enrollment as the time of origin, incident major adverse cardiac events (MACEs) were identified by subsequent chart review and defined as a composite end point of myocardial infarction, coronary revascularization, transient ischemic attack, stroke, or death from a cardiac cause.

RESULTS

Patients had a mean age of 68 ± 8 years, were largely white (75%), and had comorbidities commonly associated with PAD including hypertension (92%), hyperlipidemia (87%), coronary artery disease (37%), and diabetes mellitus (38%). After stratification by resistin quartile, higher resistin quartiles were significantly associated with an older age, a greater number of pack-years smoked, and a lower estimated glomerular filtration rate. Despite similar comorbidities and medication use, endothelial function, as measured by FMD, was significantly lower with increasing resistin quartile (I, 9.1% ± 3.3%; II, 7.1% ± 3.5%; III, 5.8% ± 4.0%; IV, 5.6% ± 3.5%; P = .002). In multivariable linear regression, higher resistin quartiles (III and IV) were associated with lower FMD relative to quartile I after adjusting for several patient characteristics, medications, and comorbidities (III, -2.26 [95% confidence interval (CI), -4.51 to -0.01; P = .05]; IV, -2.53 [95% CI, -4.87 to -0.20; P = .03]). During a median follow-up period of 36 months (interquartile range, 29-45 months), 21 patients experienced the primary end point. In a Cox proportional hazards model adjusted for smoking status, coronary artery disease, and age, each 1 ng/mL increase in resistin was associated with a 10% increased risk of MACEs (hazard ratio, 1.10; 95% CI, 1.00-1.20; P = .04).

CONCLUSIONS

In patients with PAD, higher levels of resistin were associated with impaired endothelial function and an increased rate of MACEs. These results suggest that resistin may be a marker or effector of impaired vascular physiology and adverse cardiac outcomes in patients with PAD. Further research is needed to determine the potential mechanisms by which resistin may impair endothelial function and increase MACEs in this population.

Adipokines at the crossroad between obesity and cardiovascular disease

Obesity, and especially excessive visceral adipose tissue accumulation, is considered as a low-grade inflammatory state that is responsible for adipocyte dysfunction and associated metabolic disorders. Adipose tissue displays endocrine functions by releasing pro- or antiinflammatory bioactive molecules named adipokines. An altered expression of these molecules, provoked by obesity or adipocyte dysregulation, contributes to major metabolic diseases such as insulin resistance and type 2 diabetes mellitus that are important risk factors for cardiovascular disease. However, obesity is also characterised by the expansion of perivascular adipose tissue that acts locally via diffusion of adipokines into the vascular wall. Local inflammation within blood vessels induced by adipokines contributes to the onset of endothelial dysfunction, atherosclerosis and thrombosis, but also to vascular remodelling and hypertension. A fast expansion of obesity is expected in the near future, which will rapidly increase the incidence of these cardiovascular diseases. The focus of this review is to summarise the link between metabolic and cardiovascular disease and discuss current treatment approaches, limitations and future perspectives for more targeted therapies.

Obesity-Induced Changes in Adipose Tissue Microenvironment and Their Impact on Cardiovascular Disease

Obesity is causally linked with the development of cardiovascular disorders. Accumulating evidence indicates that cardiovascular disease is the collateral damage of obesity-driven adipose tissue dysfunction that promotes a chronic inflammatory state within the organism. Adipose tissues secrete bioactive substances, referred to as adipokines, which largely function as modulators of inflammation. The microenvironment of adipose tissue will affect the adipokine secretome, having actions on remote tissues. Obesity typically leads to the upregulation of proinflammatory adipokines and the downregulation of anti-inflammatory adipokines, thereby contributing to the pathogenesis of cardiovascular diseases. In this review, we focus on the microenvironment of adipose tissue and how it influences cardiovascular disorders, including atherosclerosis and ischemic heart diseases, through the systemic actions of adipokines.

Elective percutaneous coronary intervention leads to significant changes in serum resistin, leptin, and adiponectin levels regardless of periprocedural myocardial injury: an observational study

Objective:

Bioactive roles of adipokines in coronary atherosclerosis and acute coronary syndromes have been demonstrated previously. However, there is a lack of data regarding the relationship between serum adipokines and periprocedural myocardial injury (PMI) following elective percutaneous coronary intervention (PCI). Therefore, we aimed to investigate the association between serum adipokines and PMI related to elective PCI.

Methods:

In total, 153 consecutive patients (aged 60.6±8.2 years, 98 men) with stable angina pectoris undergoing elective PCI were enrolled in this observational cross-sectional study. Serum resistin, leptin, adiponectin, and high-sensitive Troponin T (hscTnT) levels were measured immediately before PCI and after 12-h PCI. The no-injury, PMI, and type 4a myocardial infarction (type 4a MI) groups were defined as groups consisting patients with post-procedural hscTnT concentrations <14 ng/L, between 14–70 ng/L, and >70 ng/L, respectively.

Results:

Serum hscTnT, resistin, and leptin concentrations significantly (p<0.001) increased while serum adiponectin levels decreased (p<0.001) after 12-h elective PCI. However, no correlation was found between post-procedural hscTnT concentrations and resistin, leptin, and adiponectin levels. The no-injury group consisted of 65 patients (42.4%), whereas PMI and type 4a MI were observed in 70 (45.8%) and 18 (11.8%) patients, respectively. The average pre-procedural and post-procedural resistin, leptin, and adiponectin levels did not show any significant difference in the no-injury, PMI, and type 4a MI groups.

Conclusion:

There is no correlation between serum adipokine levels and post-procedural troponin elevations reflecting PMI or type 4a MI. However, serum resistin and leptin levels increase, whereas adiponectin levels decrease significantly after elective PCI.

Adipokines and endothelial dysfunction in acute myocardial infarction and the risk of recurrent cardiovascular events

AIMS

The aim of the study was to evaluate the prognostic role of adipokines (adiponectin, apelin, resistin, and visfatin) in patients with acute myocardial infarction (AMI) in relation to the extent of glucose metabolism impairment and intensity of systemic low-grade inflammation.

METHODS

This case-control study covered 131 patients with coronary artery disease: 104 consecutive patients with AMI (74% men, mean age of 62 ± 11 years) treated with primary percutaneous coronary intervention with stent implantation, and 27 patients with stable angina (70% men, mean age of 63 ± 11 years), who were initially assessed in terms of adipokine levels, C-reactive protein and various echocardiographic and vascular parameters. Major adverse cardiovascular events were recorded in the AMI group during 3-year follow-up.

RESULTS

Resistin and visfatin serum levels were significantly higher (P < 0.001), and adiponectin and apelin were lower (P < 0.001) in AMI patients as compared to patients with stable angina. In AMI patients, adipokine levels were not related to glucose metabolism disturbances, yet adiponectin (P = 0.03) and resistin (P = 0.001) concentrations were related to the number of affected coronary vessels. Serum adiponectin level correlated negatively (r = -0.608, P < 0.05), whereas resistin and visfatin correlated positively (r = 0.526, P < 0.05 and r = 0.352, P < 0.05, respectively) with C-reactive protein levels. All of the analyzed adipokines significantly accounted for the flow-mediated dilation variability (Radjusted 32%) in the AMI group. The Cox survival analysis indicated that resistin and visfatin were independent risk factors of recurrent AMI/unstable angina, with the diagnostic threshold above 12.2 ng/ml for resistin and above 11.8 ng/ml for visfatin concentrations.

CONCLUSION

An abnormal profile in serum adipokines observed in AMI is related to systemic inflammation and the degree of atherosclerosis independently of glucose metabolism disturbances and heralds major adverse cardiovascular event occurrence in long-term observation.

Resistin and right ventricular function in children with recently diagnosed type-1 diabetes mellitus: a case control study

BACKGROUND

Resistin is an adipocyte-derived signaling polypeptide described in adipose tissue, which acts as a metabolic link between inflammation and atherosclerosis. This study aimed to assess the relation between right ventricular (RV) function assessed by echocardiography and resistin levels in recently diagnosed type-1 diabetic children.

METHODS

The study was conducted as a prospective cohort study and it included 30 children with type-1 diabetes mellitus as a patient group and 30 healthy children matched for age and sex as controls. It evaluated RV functions by tissue Doppler imaging, speckle tracking imaging, and real-time three-dimensional echocardiography (RT3DE), as well as assessing resistin serum level using enzyme-linked immunosorbent assay.

RESULTS

The left ventricle (LV) showed no significant difference between the two groups in E/A ratio across the mitral valve, ejection fraction, and S wave mitral annulus. However, it showed significant decrease in the E'/A' wave of mitral annulus, impairment of LV myocardial performance index (MPI), and decrease in LV EF measured by RT3DE in diabetic patients compared to the control group. Significant differences in the mean value of tricuspid annular systolic excursion (TASE), pulmonary artery pressure, longitudinal systolic strain (RV LSS), MPI, and RV ejection fraction were observed between the studied groups. Yet, no significant differences in E/A ratio and S value were observed between the two groups. Significant positive correlation of resistin level with age of studied group and significant negative correlation of resistin with both TASE and RV LSS values were also observed.

CONCLUSION

We confirmed the presence of subclinical RV systolic and diastolic dysfunction in type-1 diabetic children with positive correlation between resistin level and RV dysfunction among them.

Obesity and coronary microvascular disease - implications for adipose tissue-mediated remote inflammatory response

It is believed that obesity has detrimental effects on the coronary circulation. These include immediate changes in coronary arterial vasomotor responsiveness and the development of occlusive large coronary artery disease. Despite its critical role in regulating myocardial perfusion, the altered behavior of coronary resistance arteries, which gives rise to coronary microvascular disease (CMD) is poorly understood in obesity. A chronic, low-grade vascular inflammation has been long considered as one of the main underlying pathology behind CMD. The expanded adipose tissue and the infiltrating macrophages are the major sources of pro-inflammatory mediators that have been implicated in causing inadequate myocardial perfusion and, in a long term, development of heart failure in obese patients. Much less is known the mechanisms regulating the release of these cytokines into the circulation that enable them to exert their remote effects in the coronary microcirculation. This mini review aims to examine recent studies describing alterations in the vasomotor function of coronary resistance arteries and the role of adipose tissue-derived pro-inflammatory cytokines and adipokines in contributing to CMD in obesity. We provide examples of regulatory mechanisms by which adipokines are released from adipose tissue to exert their remote inflammatory effects on coronary microvessels. We identify some of the important challenges and opportunities going forward.

Serum adipokine and inflammatory markers before and after liver transplantation in recipients with major cardiovascular events

In the nontransplant setting, aberrant serum adipokine levels are associated with cardiovascular (CV) disease. The effects of liver transplantation (LT) on serum adipokine levels and their association with post-LT CV disease have not been studied. A nested case-control study of 77 patients with major CV events more than 4 months after LT analyzed serum adiponectin, resistin, leptin, C-reactive protein, and apolipoprotein levels measured before transplantation and 4, 12, and 24 months after LT. Adiponectin and resistin levels decreased dramatically after LT in all patients. Recipients with CV disease had lower levels of adiponectin and higher levels of resistin, leptin, C-reactive protein, and apolipoprotein B100 than controls. The pre-LT adiponectin level was associated with a 16% increased risk for CV events for every 1 μg/mL decrease in adiponectin [hazard ratio (HR) = 0.84, P = 0.046]. Pre-LT C-reactive protein levels (HR = 1.03, P = 0.047) and 12-month C-reactive protein levels (HR = 1.03, P = 0.03) were associated with CV events after LT. Pre-LT Diabetes (HR = 2.14, P = 0.09), and post-LT resistin (HR = 1.07, P = 0.07), and apolipoprotein B (HR = 1.08, P = 0.08) were associated with a nonsignificantly increased risk of CV events in this small sample size. In conclusion, pre- and post-LT changes in serum adipokine and inflammatory markers may be signals of an increased risk of CV events after LT, but further study is needed.

Resistin in rodents and humans

Obesity is characterized by excess accumulation of lipids in adipose tissue and other organs, and chronic inflammation associated with insulin resistance and an increased risk of type 2 diabetes. Obesity, type 2 diabetes, and cardiovascular diseases are major health concerns. Resistin was first discovered as an adipose-secreted hormone (adipokine) linked to obesity and insulin resistance in rodents. Adipocyte-derived resistin is increased in obese rodents and strongly related to insulin resistance. However, in contrast to rodents, resistin is expressed and secreted from macrophages in humans and is increased in inflammatory conditions. Some studies have also suggested an association between increased resistin levels and insulin resistance, diabetes and cardiovascular disease. Genetic studies have provided additional evidence for a role of resistin in insulin resistance and inflammation. Resistin appears to mediate the pathogenesis of atherosclerosis by promoting endothelial dysfunction, vascular smooth muscle cell proliferation, arterial inflammation, and formation of foam cells. Indeed, resistin is predictive of atherosclerosis and poor clinical outcomes in patients with coronary artery disease and ischemic stroke. There is also growing evidence that elevated resistin is associated with the development of heart failure. This review will focus on the biology of resistin in rodents and humans, and evidence linking resistin with type 2 diabetes, atherosclerosis, and cardiovascular disease.

The association of resistin with coronary disease in the general population

AIMS

To explore the association between resistin expression and the incidence of ischemic heart disease in the general population.

METHODS

A follow-up study of 6636 adults recruited randomly from the general population.

RESULTS

The serum resistin concentration was higher in women (6.1 ng/mL; CI95%=6.0-6.2) than in men (5.6 ng/mL; CI95%=5.5-5.7). Individuals in the 5th quintile or higher of resistin (RQ5) were younger (P＜0.001) and had a lower prevalence of arterial hypertension (P＜0.001), abdominal obesity (P＜0.001), diabetes (P＜0.001) and dyslipidemia (P＜0.001). The cardiovascular risk estimated by the Framingham function was also lower in the RQ5 subgroup (P＜0.001); however, the prevalence of smoking was higher (P＜0.001), as was the prevalence of low HDL cholesterol (P＜0.001). After 3.5 years of follow-up, the RQ5 subgroup had a higher incidence of acute myocardial infarction (AMI, RR=1.9; CI95%=1.01-3.54). In the population without diabetes, the RQ5 subgroup had a higher risk of AMI (RR=2.4; CI95%=1.10-5.17), and the risk of AMI was highest in women in this group (4.97; CI95%=1.33-18.57). The risk levels were significant in the Cox models adjusted for age, sex and smoking; and the hazard ratio was 2.5 for AMI (CI95%=1.29-4.70) in the sample of patients matched by sex and smoking status.

CONCLUSIONS

Resistin may be a risk marker for ischemic heart disease in the general population. The serum resistin concentration is higher in women, and the associated increase in the risk of AMI based on the resistin level is also higher in women than in men.

Insulin resistance as a predictor of cardiovascular disease in patients on peritoneal dialysis

BACKGROUND

Insulin resistance is associated with multiple risk factors for cardiovascular (CV) disease in the general population. Patients on peritoneal dialysis (PD) are more likely to develop insulin resistance. However, no evaluation of the impact of insulin resistance on CV disease morbidity or mortality in patients on PD has been performed.

METHODS

Our prospective cohort study included all non-diabetic patients on PD at our center (n = 66). Insulin resistance was evaluated at baseline by the homeostasis model assessment method (HOMA-IR) using fasting glucose and insulin levels. The cohort was followed for up to 58 months (median: 41.3 months; interquartile range: 34.3 months). A multivariate Cox model was used to analyze the impact of insulin resistance on CV disease mortality.

RESULTS

Fourteen CV events occurred in the higher HOMA-IR group [IR-H (HOMA-IR values in the range 2.85 - 19.5), n = 33], but only one event occurred in the lower HOMA-IR group (IR-L (HOMA-IR values in the range 0.83 - 2.71), n = 33) during the follow-up period. Level of HOMA-IR was a significant predictor of CV events [risk ratio: 17.7; 95% confidence interval (CI): 2.10 to 149.5; p = 0.008]. In the IR-H group, 10 patients died (8 CV events), but in the IR-L group, only 4 patients died (1 CV event). Patients in the IR-H group experienced significantly higher CV mortality (hazard ratio: 9.02; 95% CI: 1.13 to 72.2; p = 0.04). Even after adjustments for age, systolic blood pressure, body mass index, C-reactive protein, triglycerides, resistin, and leptin, HOMA-IR remained an independent predictor of CV mortality (hazard ratio: 14.8; 95% CI: 1.22 to 179.1; p = 0.03).

CONCLUSIONS

Insulin resistance assessed using HOMA-IR was an independent predictor of CV morbidity and mortality in a cohort of nondiabetic patients on PD. Insulin resistance is a modifiable risk factor; the reduction of insulin resistance may reduce CV risk and improve survival in this group of patients.

Alteration of some inflammatory biomarkers by dietary oxysterols in rats

Oxysterols are structurally similar to cholesterol, but are characterized by one or more additional oxygen-containing functional groups. These compounds are implicated in inflammation given their ability to cause irreversible damage to vascular cells. The aim of this study was to study the alteration of some inflammatory biomarkers in Wistar rats in response to dietary oxysterols. Eighteen rats were randomly divided into three groups of six rats each. A standard diet supplemented with 1% (w/w) pure cholesterol (Chol group) or 1% (w/w) of an oxidized cholesterol mixture (COPs group) was fed for 8 weeks. Blood serum was separated; abdominal, pericardial, and epididymal adipose tissue was removed carefully. The COPs subjects exhibited significant increase in blood pressure and serum triacylgycerols as well as increased body fat index and pericardic, abdominal, and epididymal adipose tissue. These effects were accompanied by elevated circulating levels of plasma high-sensitivity C-reactive protein, tumor necrosis factor alpha, and resistin. We suggest that dietary oxysterols have an important pro-inflammatory effect.

Association of resistin gene polymorphisms with insulin resistance in Egyptian obese patients

BACKGROUND

Obesity associated insulin resistance is a major risk factor for type 2 diabetes mellitus. Resistin is recently reported to provide a link between obesity, insulin resistance and type 2 diabetes mellitus. We aimed to investigate the possible associations of resistin gene (RETN) polymorphisms with obesity, and to detect whether these polymorphisms are associated with glucose intolerance and type 2 diabetes mellitus in obese patients.

METHODS

One hundred and forty-five Egyptian obese patients with or without glucose intolerance and 155 unrelated healthy controls were enrolled in this study. Polymorphisms of RETN +299G>A and RETN -420 C>G gene were detected by polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP). Serum resistin was measured by ELISA.

RESULTS

RETN +299 AA and RETN -420 GG genotypes were significantly associated with obesity in Egyptian population. Moreover, the mutant alleles or genotypes of both examined polymorphisms were associated with impaired glucose tolerance and diabetes mellitus compared to normal glucose tolerant obese patients. Furthermore, our results revealed elevated waist/hip ratio, BMI, blood pressure, fasting blood glucose level, HOMA-IR, triglycerides, total cholesterol, resistin level, and decreased HDL cholesterol level in homozygote mutant genotypes carriers of both RETN polymorphisms among obese patients.

CONCLUSION

Resistin gene polymorphisms may play an important role in pathogenesis and susceptibility to obesity, impaired glucose tolerance, and type 2 diabetes mellitus in Egyptian population.

Human resistin in cardiovascular disease

An adipokine, resistin, was discovered as a potential mediator of obesity related insulin resistance in rodents. However, the relevance of resistin in human obesity and insulin resistance has been challenged by the difference between human and rodent resistin and the controversies in human epidemiologic studies. Instead, recent human clinical studies and experiments support the idea that human resistin is an inflammatory mediator and a biomarker of cardiovascular diseases, especially in atherosclerosis and heart failure. Thus, we focused on the recent evidence of the role of human resistin in cardiovascular disease.

Resistin levels in lupus and associations with disease-specific measures, insulin resistance, and coronary calcification

OBJECTIVE

To evaluate levels of resistin in female subjects with systemic lupus erythematosus (SLE) compared to age and race-matched controls and to determine the relationship between resistin and systemic inflammation, disease measures, and coronary artery calcification (CAC).

METHODS

Resistin levels were measured on stored samples from 159 women with SLE and 70 controls as an extension of a previous cross-sectional study. Spearman correlations and multivariable regressions were used to examine whether resistin levels were associated with SLE, disease-specific and inflammatory markers, insulin resistance, and CAC.

RESULTS

In a multivariable linear regression model, a diagnosis of SLE was significantly associated with higher resistin levels independent of age, race, renal function, body mass index (BMI), high-sensitivity CRP (hsCRP), hypertension, diabetes, and steroid use. In SLE, resistin levels correlated positively with Systemic Lupus International Collaborating Clinics Damage Index, glomerular filtration rate (GFR), hsCRP, erythrocyte sedimentation rate, homocysteine, and disease duration (all p < 0.03). Resistin level did not correlate with markers of insulin resistance or body adiposity, including homeostatic model assessment or BMI. Resistin levels were significantly elevated in SLE cases with CAC compared to cases without CAC (16.58 vs 13.10 ng/ml, respectively; p = 0.04). In multivariate logistic regression, the association was not present after adjustment for age, race, and GFR.

CONCLUSION

SLE was independently associated with higher resistin levels. Among subjects with SLE, higher resistin level correlated positively with renal dysfunction, inflammatory markers, and disease damage but not with insulin resistance or BMI. SLE cases with CAC had higher resistin levels than cases without CAC; however, this relationship was dependent on other established risk factors.

Human resistin: found in translation from mouse to man

The discovery of resistin 10 years ago as a fat cell-secreted factor that modulates insulin resistance suggested a link to the current obesity-associated epidemics of diabetes and cardiovascular disease, which are major human health concerns. Although adipocyte-derived resistin is indisputably linked to insulin resistance in rodent models, the relevance of human resistin is complicated because human resistin is secreted by macrophages rather than adipocytes, and because of the descriptive nature of human epidemiology. In this review, we examine the recent and growing evidence that human resistin is an inflammatory biomarker and a potential mediator of diabetes and cardiovascular disease.