Adipokines and endothelial dysfunction in obesity WHO°III

Area of Science:

• Cardiovascular Research
• Metabolic Disorders
• Ophthalmology

Background:

• Obesity, particularly WHO°III, is linked to metabolic syndrome (MetS), low-grade inflammation, and endothelial dysfunction (ED), increasing cardiovascular disease risk.
• The specific role of adipokines in retinal ED within the context of severe obesity remains unclear.
• Understanding these relationships is crucial for managing cardiovascular complications in obese individuals.

Purpose of the Study:

• To investigate the association between MetS, specific adipokines, and retinal ED in patients with WHO°III obesity.
• To determine if MetS or inflammation markers correlate with retinal vascular changes in severe obesity.
• To explore the impact of adipokines like adiponectin on retinal vessel diameter.

Main Methods:

• Assessed 92 patients with WHO°III obesity for MetS (IDF criteria), neck circumference, adipokines, and inflammatory markers (hsCRP, TNFα, IL-6, MCP-1, sICAM, sVCAM, IGF-BP3, RBP 4, adiponectin).
• Measured retinal ED using arterio-venous ratio (AVR) and retinal vessel diameters (central retinal artery/vein equivalents - CRAE/CRVE) from retinal photographs.
• Compared MetS-positive (MetS+) and MetS-negative (MetS-) groups based on clinical and biochemical parameters.

Main Results:

• MetS+ patients exhibited significant differences in neck circumference, glucose metabolism (fasting glucose, insulin, HOMA-IR), triglycerides, and HDL-C compared to MetS- patients.
• Key inflammatory markers (IL-6, sICAM) and adiponectin levels differed significantly between MetS+ and MetS- groups.
• Despite biochemical and anthropometric differences, no significant differences in retinal ED measures (AVR, CRAE, CRVE) were observed between the MetS+ and MetS- groups.

Conclusions:

• Retinal endothelial dysfunction in WHO°III obesity appears to be independent of the presence of metabolic syndrome or systemic inflammation.
• Neck circumference showed a significant association with ED in obese patients with MetS.
• Adiponectin was associated with central retinal artery equivalent (CRAE) in obese patients without MetS, suggesting a potential role in vascular health independent of MetS criteria.