Evaluation of circulating adipokines and abdominal obesity as predictors of significant myocardial ischemia using gated single-photon emission computed tomography
Journal
PLoS ONE
Journal Volume
9
Journal Issue
5
Date Issued
2014
Author(s)
Abstract
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. ? 2014 Hung et al.
SDGs
Other Subjects
adiponectin; C reactive protein; chemerin; fatty acid binding protein 4; triacylglycerol; adipocytokine; adiponectin; FABP4 protein, human; fatty acid binding protein; abdominal obesity; adult; article; body mass; concentration (parameters); controlled study; coronary artery disease; cross-sectional study; female; heart muscle ischemia; heart muscle perfusion; heart muscle revascularization; human; intraabdominal fat; major clinical study; male; pathogenesis; risk factor; single photon emission computer tomography; triacylglycerol blood level; waist circumference; abdominal obesity; area under the curve; blood; complication; Myocardial Ischemia; pathology; procedures; receiver operating characteristic; risk; single photon emission computer tomography; Adipokines; Adiponectin; Area Under Curve; Body Mass Index; Fatty Acid-Binding Proteins; Humans; Myocardial Ischemia; Obesity, Abdominal; Odds Ratio; Risk Factors; ROC Curve; Tomography, Emission-Computed, Single-Photon; Waist Circumference
Type
journal article