Abstract
Background: A number of cytokines and adipokines secreted by adipose tissue may influence vessel wall directly. Adiponectin exhibits anti-inflammatory and atheroprotective actions. Resistin is expressed at higher levels in inflammatory cells. Resistin directly activates the endothelium through upreglation of adhesion molecules, induces production of TNF-α by macrophages, effects that are antagonized by adiponectin. Leptin has multiple effects on cells of artery walls, many similar to those of resistin. The prognostic role of adipokines in atherosclerosis is not well established. Methods: We compared the baseline plasma levels of adiponectin, resistin, leptin and TNF-α (ELISA assays) in 59 patients with coronary artery disease (CAD) and 32 patients with peripheral artery disease (PAD). Also, we investigated the impact of baseline plasma levels of adiponectin, resistin, leptin and TNF-α on the incidence of the new ischemic cardiovascular events. Results: In patients with CAD, as compared with PAD, baseline plasma levels of leptin were significantly increased (2882.02 ± 368.57pg/ml vs 1025.56 ± 232.28 pg/ml; p<0.001), plasma levels of resistin were significantly decreased (13.15 ± 0.83ng/ml vs 17.76 ± 2.13 ng/ml; p = 0.02) and no differences in plasma levels of adiponectin and TNF-α were found. A significant correlation between BMI and plasma levels was found only for leptin, irrespective of group. 45 patients (49.5%) were re-hospitalized in a 2 years period of follow-up. In a backward stepwise multivariable Cox regression analysis only resistin ≥ 15 ng/ ml, HR =1.8829, 95% CI 1.0490- 3.3797, p = 0.034 and diastolic blood pressure ≥ 85 mmHg, HR =2.0927, 95%CI 1.0782- 4.0616, p=0.0299 were associated with new cardiovascular events. Conclussion: In patients with clinical atherosclerosis plasma levels of resistin predict new ischemc events.