Association between Omentin-1 and Major Cardiovascular Events After Lower Extremity Endovascular Revascularization in Diabetic Patients: A Prospective Cohort Study

Abstract

Background: Cardiovascular complications represent the major cause of morbidity and mortality of type 2 diabetes mellitus (T2DM) patients. In particular, peripheral artery disease (PAD) represents a frequent T2DM vascular complication and a risk factor for the development of major adverse cardiovascular events (MACE). Among adipokines, Omentin-1 serum levels are reduced in T2DM patients with PAD and are inversely related to disease severity.Objective: To study the relationship between Omentin-1 levels, at baseline, with outcomes after endovascular procedures in T2DM patients with PAD and chronic limb-threatening ischemia (CLTI).Research Design and Methods: We enrolled for our prospective non-randomized study, 207 T2DM patients with PAD and CLTI, requiring revascularization. Omentin-1 serum levels were collected before revascularization and patients incidence outcomes were evaluated at 1, 3, 6 and 12 months.Results: Omentin-1 was reduced in patients with more severe disease (27.24 ± 4.83 ng/mL vs 30.82 ± 5.48 ng/mL, p < 0.001). Overall, 84 MACE and 96 major adverse limb events (MALE) occurred during the 12-month follow-up. We observed that Omentin-1 levels were lower in patients with MACE (26.02 ± 4.05 ng/mL vs 31.33 ± 5.29 ng/mL, p < 0.001) and MALE (26.67 ± 4.21 ng/mL vs 31.34 ± 5.54 ng/mL, p < 0.001). The association between Omentin-1, MACE and MALE remained significant after adjusting for major risk factors in a multivariate analysis. Receiver operating characteristics (ROC) curve using Omentin-1 levels predicted incidence events (area under the curve = 0.80).Conclusions: We demonstrated that reduced Omentin-1 levels, at baseline, are related with worse vascular outcomes in T2DM patients with PAD and CLTI undergoing an endovascular procedure.