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Association between resistin levels and all-cause and cardiovascular mortality: a new study and a systematic review
Andrea Fontana1, Sara Spadaro2, Massimiliano Copetti1
1Unit of Biostatistics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy.
Insights
This study found that higher resistin levels are linked to increased all-cause and cardiovascular mortality risk in high-risk patients. These findings clarify conflicting previous research on resistin and mortality.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Epidemiology
Background:
- Conflicting results exist regarding the association between circulating resistin and mortality risk.
- Resistin, an adipokine, plays a role in metabolic and inflammatory processes.
Purpose of the Study:
- To investigate the association between resistin and all-cause and cardiovascular mortality.
- To analyze data from the Gargano Heart Study (GHS) and perform meta-analyses of published studies.
Main Methods:
- Conducted a prospective study (GHS) with 359 patients.
- Performed systematic literature searches on MEDLINE and Web of Science.
- Included 7 studies (4016 participants) for all-cause mortality and 6 studies (4187 participants) for cardiovascular mortality in meta-analyses.
Main Results:
- In GHS, increased resistin was associated with higher all-cause (HR 1.28) and cardiovascular mortality (HR 1.32).
- Pooled meta-analyses showed a significant association between resistin and all-cause mortality (HR 1.21).
- Study mean age partially explained heterogeneity in all-cause mortality meta-regression.
Conclusions:
- Circulating resistin is associated with increased mortality risk in high-risk patients, including those with diabetes and coronary artery disease.
- These findings contribute to understanding resistin's role in cardiovascular outcomes.
Context:
Studies concerning the association between circulating resistin and mortality risk have reported, so far, conflicting results.
Objective:
To investigate the association between resistin and both all-cause and cardiovascular (CV) mortality risk by 1) analyzing data from the Gargano Heart Study (GHS) prospective design (n=359 patients; 81 and 58 all-cause and CV deaths, respectively); 2) performing meta-analyses of all published studies addressing the above mentioned associations.
Data Source And Study Selection:
MEDLINE and Web of Science search of studies reporting hazard ratios (HR) of circulating resistin for all-cause or CV mortality.
Data Extraction:
Performed independently by two investigators, using a standardized data extraction sheet.
Data Synthesis:
In GHS, adjusted HRs per one standard deviation (SD) increment in resistin concentration were 1.28 (95% CI: 1.07-1.54) and 1.32 (95% CI: 1.06-1.64) for all-cause and CV mortality, respectively. The meta-analyses included 7 studies (n=4016; 961 events) for all-cause mortality and 6 studies (n=4,187: 412 events) for CV mortality. Pooled HRs per one SD increment in resistin levels were 1.21 (95% CI: 1.03-1.42, Q-test p for heterogeneity<0.001) and 1.05 (95% CI: 1.01-1.10, Q-test p for heterogeneity=0.199) for all-cause and CV mortality, respectively. At meta-regression analyses, study mean age explained 9.9% of all-cause mortality studies heterogeneity. After adjusting for age, HR for all-cause mortality was 1.24 (95% CI: 1.06-1.45).
Conclusions:
Our results provide evidence for an association between circulating resistin and mortality risk among high-risk patients as are those with diabetes and coronary artery disease.
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