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Evaluation of Circulating Adipokines and Abdominal Obesity as Predictors of Significant Myocardial Ischemia Using Gated Single-Photon Emission Computed Tomography
OBJECTIVE: Coronary artery disease (CAD) is associated with abdominal obesity and metabolic syndrome. Adipocytes secrete adipokines, including the newly discovered adipocyte fatty acid binding protein (A-FABP) and chemerin. Adipokines contribute to the pathogenesis of CAD. In patients with CAD, the...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4026442/ https://www.ncbi.nlm.nih.gov/pubmed/24842767 http://dx.doi.org/10.1371/journal.pone.0097710 |
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author | Hung, Chi-Sheng Wu, Yen-Wen Huang, Jei-Yie Hsu, Pei-Ying Chen, Ming-Fong |
author_facet | Hung, Chi-Sheng Wu, Yen-Wen Huang, Jei-Yie Hsu, Pei-Ying Chen, Ming-Fong |
author_sort | Hung, Chi-Sheng |
collection | PubMed |
description | OBJECTIVE: Coronary artery disease (CAD) is associated with abdominal obesity and metabolic syndrome. Adipocytes secrete adipokines, including the newly discovered adipocyte fatty acid binding protein (A-FABP) and chemerin. Adipokines contribute to the pathogenesis of CAD. In patients with CAD, the presence of significant ischemia predicts adverse outcomes. It is unknown whether adipokines can be better predictors of the presence of significant myocardial ischemia than conventional risk factors. This study aimed to compare adipokines with clinical risk factors and abdominal obesity as predictive factors for significant myocardial ischemia. METHODS: One hundred and ninety-six adults with suspected, but unproven, CAD were consecutively enrolled. The main measures were clinical and biochemical parameters and stress myocardial perfusion imaging with gated myocardial perfusion single-photon emission computed tomography (SPECT), with computed tomography (CT) attenuation correction. The abdominal visceral fat area was examined using a hybrid SPECT/CT scanner. Serum levels of high-sensitivity C-reactive protein (hs-CRP) and adipokines (adiponectin, A-FABP, and chemerin) were evaluated. RESULTS: A-FABP levels correlated significantly with adiponectin, hs-CRP, body mass index, waist circumference, and visceral fat area. A-FABP was significantly associated with metabolic syndrome (OR 3.2, 95% CI 1.6–6.4, p = 0.001), significant myocardial ischemia (OR 1.9, 95% CI 1.0–3.4, p = 0.05), and stress lung-to-heart ratio (β = 0.03, p = 0.03) on SPECT. Chemerin was significantly associated with serum triglyceride levels but not with metabolic syndrome, significant ischemia, or stress lung-to-heart ratio on SPECT. A-FABP was better at detecting significant inducible ischemia than other biomarkers, although this was a modest improvement (area under ROC curve 0.579, 95% CI 0.46–0.69). CONCLUSIONS: Serum A-FABP concentrations correlate significantly with visceral fat area, metabolic syndrome, and predicted significant myocardial ischemia on SPECT. This may help to more accurately assess CAD risk, especially in patients with metabolic syndrome. |
format | Online Article Text |
id | pubmed-4026442 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-40264422014-05-21 Evaluation of Circulating Adipokines and Abdominal Obesity as Predictors of Significant Myocardial Ischemia Using Gated Single-Photon Emission Computed Tomography Hung, Chi-Sheng Wu, Yen-Wen Huang, Jei-Yie Hsu, Pei-Ying Chen, Ming-Fong PLoS One Research Article OBJECTIVE: Coronary artery disease (CAD) is associated with abdominal obesity and metabolic syndrome. Adipocytes secrete adipokines, including the newly discovered adipocyte fatty acid binding protein (A-FABP) and chemerin. Adipokines contribute to the pathogenesis of CAD. In patients with CAD, the presence of significant ischemia predicts adverse outcomes. It is unknown whether adipokines can be better predictors of the presence of significant myocardial ischemia than conventional risk factors. This study aimed to compare adipokines with clinical risk factors and abdominal obesity as predictive factors for significant myocardial ischemia. METHODS: One hundred and ninety-six adults with suspected, but unproven, CAD were consecutively enrolled. The main measures were clinical and biochemical parameters and stress myocardial perfusion imaging with gated myocardial perfusion single-photon emission computed tomography (SPECT), with computed tomography (CT) attenuation correction. The abdominal visceral fat area was examined using a hybrid SPECT/CT scanner. Serum levels of high-sensitivity C-reactive protein (hs-CRP) and adipokines (adiponectin, A-FABP, and chemerin) were evaluated. RESULTS: A-FABP levels correlated significantly with adiponectin, hs-CRP, body mass index, waist circumference, and visceral fat area. A-FABP was significantly associated with metabolic syndrome (OR 3.2, 95% CI 1.6–6.4, p = 0.001), significant myocardial ischemia (OR 1.9, 95% CI 1.0–3.4, p = 0.05), and stress lung-to-heart ratio (β = 0.03, p = 0.03) on SPECT. Chemerin was significantly associated with serum triglyceride levels but not with metabolic syndrome, significant ischemia, or stress lung-to-heart ratio on SPECT. A-FABP was better at detecting significant inducible ischemia than other biomarkers, although this was a modest improvement (area under ROC curve 0.579, 95% CI 0.46–0.69). CONCLUSIONS: Serum A-FABP concentrations correlate significantly with visceral fat area, metabolic syndrome, and predicted significant myocardial ischemia on SPECT. This may help to more accurately assess CAD risk, especially in patients with metabolic syndrome. Public Library of Science 2014-05-19 /pmc/articles/PMC4026442/ /pubmed/24842767 http://dx.doi.org/10.1371/journal.pone.0097710 Text en © 2014 Hung et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Hung, Chi-Sheng Wu, Yen-Wen Huang, Jei-Yie Hsu, Pei-Ying Chen, Ming-Fong Evaluation of Circulating Adipokines and Abdominal Obesity as Predictors of Significant Myocardial Ischemia Using Gated Single-Photon Emission Computed Tomography |
title | Evaluation of Circulating Adipokines and Abdominal Obesity as Predictors of Significant Myocardial Ischemia Using Gated Single-Photon Emission Computed Tomography |
title_full | Evaluation of Circulating Adipokines and Abdominal Obesity as Predictors of Significant Myocardial Ischemia Using Gated Single-Photon Emission Computed Tomography |
title_fullStr | Evaluation of Circulating Adipokines and Abdominal Obesity as Predictors of Significant Myocardial Ischemia Using Gated Single-Photon Emission Computed Tomography |
title_full_unstemmed | Evaluation of Circulating Adipokines and Abdominal Obesity as Predictors of Significant Myocardial Ischemia Using Gated Single-Photon Emission Computed Tomography |
title_short | Evaluation of Circulating Adipokines and Abdominal Obesity as Predictors of Significant Myocardial Ischemia Using Gated Single-Photon Emission Computed Tomography |
title_sort | evaluation of circulating adipokines and abdominal obesity as predictors of significant myocardial ischemia using gated single-photon emission computed tomography |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4026442/ https://www.ncbi.nlm.nih.gov/pubmed/24842767 http://dx.doi.org/10.1371/journal.pone.0097710 |
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