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Blood adipocytokine concentration in patients with peripheral artery disease
Marta Spychalska-Zwolińska1, Marzena Anaszewicz1, Joanna Wiśniewska1
1Department of Vascular and Internal Diseases, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
Insights
Adipocytokines like TNF-α, indexed to fat mass and visceral adiposity, may predict outcomes after superficial femoral artery stenting. Diabetes mellitus is linked to altered adipocytokine levels, potentially worsening atherosclerosis.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Vascular Surgery
Background:
- Adipocytokines are implicated in atherosclerosis and in-stent restenosis.
- Understanding adipocytokine roles in peripheral artery disease (PAD) is crucial.
Purpose of the Study:
- To investigate the relationship between leptin, adiponectin, and tumor necrosis factor-α (TNF-α) levels and 1-year outcomes following superficial femoral artery (SFA) stenting.
- To explore adipocytokine profiles in patients with intermittent claudication undergoing SFA stenting versus carotid artery stenting (CAS).
Main Methods:
- Blood concentrations of leptin, adiponectin, and TNF-α were measured in 70 SFA stenting patients and 40 CAS patients.
- Follow-up for at least 1 year assessed target lesion revascularization (TLR) or major adverse cardiovascular events (MACE).
- Adipocytokine levels were analyzed in relation to fat mass (FM) and visceral adiposity score (VAS).
Main Results:
- No significant differences in adipocytokine levels were observed between SFA and CAS groups.
- Diabetic patients showed higher leptin, lower adiponectin-to-leptin ratio, and lower adiponectin indexed to FM and VAS.
- Higher TNF-α indexed to FM and VAS correlated with TLR and MACE, but TASC-II classification was the sole independent predictor of TLR.
Conclusions:
- Circulating adipocytokines did not differentiate clinical atherosclerosis manifestations.
- Elevated TNF-α relative to FM and VAS before SFA stenting predicted TLR and MACE.
- Adipocytokine dysregulation may mediate diabetes' proatherogenic effects in PAD.
Background:
Inflammatory responses mediated by adipocytokines may affect both atherosclerosis development and progression, as well as the risk of in-stent restenosis. The aim of this study was to determine the relationships between blood leptin, adiponectin and tumor necrosis factor-α (TNF-α) concentrations and the 1-year outcome of superficial femoral artery (SFA) stenting.
Methods:
Blood concentrations of leptin, adiponectin and TNF-α were determined in 70 patients undergoing SFA stenting due to intermittent claudication and in 40 patients undergoing carotid artery stenting (CAS). All subjects were followed up for at least 1 year in relation to the occurrence of clinically driven target lesion revascularization (TLR) or a major adverse cardiovascular event (MACE).
Results:
Patients undergoing SFA stenting and CAS had similar blood adipocytokine concentrations. Patients with diabetes mellitus presented a higher leptin concentration, lower adiponectin-to-leptin ratio, and lower blood adiponectin concentration indexed to fat mass (FM) and to visceral adiposity score (VAS). In Kaplan-Meier analysis, blood concentration of TNF-α indexed to FM and to VAS was higher in patients who underwent TLR and MACE. However, in multifactorial analysis, the severity of atherosclerosis lesions in the femoropopliteal vascular region, estimated in relation to TASC-II classification, was the only predictor of TLR.
Conclusions:
Circulating adipocytokines did not distinguish patients with different clinical manifestations of atherosclerosis. Higher ratios of TNF-α -to-FM and to VAS before SFA stenting were related to TLR and MACE occurrence. Dysregulation in adipocytokine secretion may be a potential mediator of a proatherogenic action of diabetes mellitus in patients with peripheral artery disease.
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