The prognostic role of RBP-4 and adiponectin in patients with peripheral arterial disease undergoing lower limb endovascular revascularization

Abstract

Background RBP4 is an adipokine with an established role in atherosclerosis, while adiponectin has unique anti-inflammatory properties. We investigated the association of RBP4 and adiponectin with the presence of symptomatic peripheral artery disease (PAD) and their possible prognostic role in major adverse cardiovascular events (MACE). Methods We enrolled 168 consecutive patients with symptomatic, established PAD, requiring revascularization by endovascular means of any or both of their lower limbs. 88 age- and sex-matched subjects with less than 2 classical cardiovascular risk factors served as controls. Clinical parameters, glycemic and lipid profile, RBP4 and adiponectin levels were assayed. The occurrence of MACE was recorded during the 6-month follow-up and patients were assigned to MACE and non-MACE subgroups. Results The presence of symptomatic PAD was significantly correlated with age, diabetes, hsCRP, RBP4 and low adiponectin levels (p < 0.05). After adjustment for age, RBP4 (β = 0.498, p < 0.001), and adiponectin (β = –0.288, p < 0.001) levels remained as independent predictors of PAD presence in the whole study cohort. At baseline, MACE subgroup appeared with higher RBP-4 and hsCRP serum levels than non-MACE subgroup (p < 0.001), but no differences were detected for adiponectin (p = 0.758). Serum RBP4 levels remained independent predictor of MACE (β = 0.455, p < 0.001) after adjustment for traditional cardiovascular risk factors. Conclusions High RBP4 and low adiponectin serum levels are independently associated with PAD presence. In addition, RBP4 is an independent predictor of MACE incidence in symptomatic PAD patients.

Adiponectin System (Rescue Hormone): The Missing Link between Metabolic and Cardiovascular Diseases

“…Ref. [ 19 ] recruited 168 patients aged 88 with peripheral artery disease (PAD) to study their potential prognostic function in major adverse cardiovascular events (MACE). It was found that an increase in RBP4 and decrease in adiponectin serum concentrations are independently linked with PAD appearance.…”

Assessment of causal associations between obesity and peripheral artery disease: a bidirectional Mendelian randomization study

“…Obesity is closely related to physiological changes such as chronic inflammation and insulin resistance, and is the main cause of various metabolic diseases such as type 2 diabetes, fatty liver and hypertension ( 5 ). Previous studies have shown that in obese patients, adipose-related factors such as Retinol-Binding Protein-4 are significantly increased, which mediate the proliferation of vascular smooth muscle cells, and increase pro-inflammatory cytokines such as Tumor necrosis factor-alpha (TNF-alpha) and interleukins 1β, 2, 8, 10 (IL-1β, IL-2, IL-8, IL-10) and adhesion molecules such as vascular cell adhesion molecule 1, thereby aggravating the occurrence and development of PAD ( 5 , 27 ). In addition, the excessive weight of obese people will increase the mechanical compression of the arteries of the lower limbs, leading to damage to the blood vessel wall and promoting the progression of PAD ( 28 ).…”

Clonal Hematopoiesis Mutations Are Present in Atherosclerotic Lesions in Peripheral Artery Disease

“…Recently, Tet2 loss-of-function mutations have been shown in mice to increase IL-1β secretion from adipose tissue and aggravate age- and obesity-related insulin resistance [ 27 ]. Perivascular fat distribution [ 25 ] and adipokine signaling [ 28 ] influence the progression of PAD and adipose tissue-derived retinol binding protein 4 predicts major adverse events in PAD patients [ 28 ]. Thus, further studies should analyze whether and how adipose tissue signaling is affected by CH.…”