Epicardial adipose tissue thickness and its association with adiponectin in metabolic syndrome patients from Mérida, Venezuela

Lima-Martínez, Marcos M.; López-Mendez, Gabriel; Odreman, Rodolfo; Donis, José H.; Paoli, Mariela

doi:10.1590/0004-2730000002888

Cited by 10 publications

(4 citation statements)

References 28 publications

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“…Multivariate linear regression demonstrated that EFA had a positive association with serum leptin (β = 0.438, P = 0.0001) after adjusting for age, sex, and BMI. Lima-Martinez et al [ 12 ] reported an inverse relationship between EAT thickness and plasma adiponectin concentration in metabolic syndrome patients. Similarly, an inverse relationship between adiponectin and visceral adipose volume measured by CT has been reported in women [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…There have been several reports of its clinical associations, especially with CAD [ 11 ]. Lima-Martinez et al [ 12 ] showed an inverse proportional relationship between EAT thickness and circulating adiponectin concentration. Similarly, an inverse relationship between adiponectin level and visceral adipose volume measured by computed tomography (CT) has been reported [ 13 ], while Harada et al [ 14 ] failed to find a significant association between epicardial fat volume and plasma levels of adiponectin.…”

Section: Introductionmentioning

confidence: 99%

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Association of serum concentrations of irisin and the adipokines adiponectin and leptin with epicardial fat in cardiovascular surgery patients

et al. 2018

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Epicardial fat located adjacent to the heart and coronary arteries is associated with increased cardiovascular risk. Irisin is a myokine produced by skeletal muscle after physical exercise, and originally described as a molecule able to promote the browning of white adipose tissue and energy expenditure. In order to decrease cardiovascular risk, it has been proposed as a promising therapeutic target in obesity and type 2 diabetes. We investigated the relationships between serum concentrations of irisin and the adipokines adiponectin and leptin and body fat including epicardial fat in patients undergoing cardiovascular surgery. We obtained serum samples from 93 patients undergoing cardiovascular surgery (age 69.6 (SD 12.8) years, BMI 24.1 ± 4.8 kg/m2). Computed tomography (CT) and echocardiographic data were obtained from the routine preoperative examination. Subcutaneous fat area (SFA, cm2) and visceral fat area (VFA, cm2) near the umbilicus were automatically measured using the standard fat attenuation range. Epicardial fat area (EFA, cm2) was measured at the position where the heart became a long axis image with respect to the apex of the heart in the coronal section image. Total body fat mass, body fat percentage, and skeletal muscle volume (SMV) were estimated using bioelectrical impedance analysis (BIA). Serum irisin concentration was measured by enzyme-linked immunosorbent assay, and compared with adiponectin and leptin concentrations. The data were also compared with the clinical biochemical data. EFA was strongly correlated with BMI (P = 0.0001), non-HDL-C (P = 0.029), TG (P = 0.004), body fat mass (P = 0.0001), and body fat percentage (P = 0.0001). Serum leptin concentration showed a significant positive correlation with BMI (P = 0.0001) and TG (P = 0.001). Adiponectin, but not irisin, showed a significant negative correlation with BMI (P = 0.006) and TG (P = 0.001). Serum leptin level had a significant positive correlation with EFA, VFA, and SFA. In contrast, the serum adiponectin level was significantly negatively correlated with EFA, VFA, and SFA. The serum irisin level was also negatively correlated with EFA (r = -0.249, P = 0.015), and SFA (r = -0.223, P = 0.039), and tended to correlate with VFA (r = -0.198, P = 0.067). The serum level of adiponectin was negatively correlated with that of leptin (r = -0.296, P = 0.012), but there were no significant correlations between irisin and either adiponectin or leptin. Multivariate linear regression demonstrated that EFA showed a positive association with serum leptin level (β = 0.438, P = 0.0001) and a negative correlation with serum irisin level (β = -0.204, P = 0.038) and serum adiponectin level (β = -0.260, P = 0.015) after adjusting for age, sex, and BMI. The present study provided the first evidence of associations of the serum irisin and adipokines (adiponectin and leptin) concentrations with epicardial fat in cardiovascular surgery patients. Irisin may play a role in preventing excess adiposity including epicardial fat, and consequently cardiovascul...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of serum concentrations of irisin and the adipokines adiponectin and leptin with epicardial fat in cardiovascular surgery patients

et al. 2018

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“…Echocardiographic epicardial fat strongly and independently reflects intra-abdominal visceral fat and intramyocardial fat content, as measured by magnetic resonance imaging (MRI) [7,8]. Several clinical studies have shown that epicardial fat thickness is significantly related to metabolic syndrome, diabetes, and coronary artery disease (CAD) [9][10][11][12][13]. Given its simple objective measurability, epicardial fat can serve as target for pharmaceutical agents targeting the adipose tissue [1,4].…”

Section: Introductionmentioning

confidence: 99%

Effect of sitagliptin on epicardial fat thickness in subjects with type 2 diabetes and obesity: a pilot study

Lima-Martínez

Paoli

Rodney³

et al. 2015

Endocrine

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The aim of the study was to assess the effect of sitagliptin addition on the epicardial adipose tissue (EAT) thickness in subjects with type 2 diabetes mellitus inadequately controlled on metformin monotherapy. This was a 24-week interventional pilot study in 26 consecutive type 2 diabetic patients, 14 females and 12 males average age of 43.8 ± 9.0 years, with Hemoglobin A1c (HbA1c) ≥ 7% on metformin monotherapy. Subjects who met the inclusion criteria were added on sitagliptin and started on sitagliptin/metformin combination at the dosage of 50 mg/1000 mg twice daily. EAT and visceral and total body fat were measured, respectively, with echocardiography and bioelectrical impedance analysis at baseline and after 24 weeks of sitagliptin/metformin treatment in each subject. HbA1c and plasma lipids were also measured. EAT decreased significantly from 9.98 ± 2.63 to 8.10 ± 2.11 mm, p = 0.001, accounting for a percentage of reduction (∆%) of -15% after 24 weeks of sitagliptin addition, whereas total body fat percentage, visceral fat, and body mass index (BMI), decreased by 8, 12, and 7%, respectively (p = 0.001 for all). After 6 month, EAT ∆% was significantly correlated with ∆% of visceral fat (r = 0.456; p = 0.01), whereas no correlation with either BMI ∆% (r = 0.292; p = 0.147) or HbA1c ∆% was found. The addition of Sitagliptin produced a significant and rapid reduction of EAT, marker of organ-specific visceral fat, in overweight/obese individuals with type 2 diabetes inadequately controlled on metformin monotherapy. EAT as measured with ultrasound can serve as no invasive and accurate marker of visceral fat changes during pharmaceutical interventions targeting the fat.

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“…W e have examined with attention the comments of the letter to the Editor in regards to our recently published article (1), and want to thank its authors for their interest in our work.…”

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Response to the letter: Angiotensin-II induced insulin resistance

Lima-Martínez

López-Mendez

Odreman

et al. 2014

Arq Bras Endocrinol Metab

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W e have examined with attention the comments of the letter to the Editor in regards to our recently published article (1), and want to thank its authors for their interest in our work.Indeed, it has been demonstrated that, upon acting on the AT1 receptor, angiotensin II activates matrix metalloproteases that release the epidermal growth factor (EGF), binding to its receptor promotes the activation of mammalian target of rapamycin (mTOR) and ribosomal S6 kinase-1, both of which inhibit phosphatidylinositol 3-kinase insulin signaling, thus favoring insulin resistance (2-4). Interestingly, some clinical studies have demonstrated that treatment with either angiotensin I-converter enzyme inhibitors (ACEI) or angiotensin II receptor antagonist (ARA) reduces the incidence of diabetes mellitus in high risk patients (5,6).Our study compared a group of metabolic syndrome (MS) patients (31 subjects) with a control group (27 subjects), and, as pointed out in the Results section, 13 out of 31 MS patients presented high blood pressure (41.9%), whereas none of the subjects in the control group were hypertensive (0%), not receiving therefore hypertension medication. As mentioned in the study, 10 of the 13 patients with high blood pressure and MS were treated with monotherapy (6 with ACEI and 4 with ARA), and the other three were on a combined therapy of ARA with calcium antagonist (2), and ACEI with a diuretic (1). Our study found that patients with MS revealed a greater thickness of epicardial adipose tissue (EAT) (5.69 ± 1.12 vs 3.52 ± 0.80 mm; p = 0.0001) in comparison with the subjects in the control group (1). As far as we know, no study has demonstrated that ARAs or ACEIs decrease EAT thickness, and although it is described that both antihypertensives drugs reduce insulin resistance, we observed that the study group had greater basal plasma insulin concentrations than those of the control group (6.08 ± 5.22 vs. 2.10 ± 0.54; p = 0.0001), and even greater trigliceryde/HDL-C ratio (4.52 ± 2.37 vs. 2.10 ± 1.15; p = 0.0001), which is considered a surrogate marker of insulin resistance (7).Furthermore, a larger left ventricular mass (60.28 ± 14.00 vs. 53.01 ± 8.40; p = 0,019) and lower adiponectin plasma levels (11.20 ± 2.65 vs. 14.95 ± 3.87; p = 0,0001) were found in subjects with MS as compared to the control group. In agreement with the comments of the letter to the Editor, both ACEI and ARA have been shown to reduce left ventricular mass; however, it is worth noting that only subjects belonging to the MS group were receiving such therapy, whereby it can be asserted that this aspect had little incidence on the results. Furthering into the beneficial effects of ACEI and ARA, new analyses were carried out, and upon comparing the patients receiving these drugs (n = 13) with those MS patients receiving different medication or not receiving antihypertensives (n = 18), the levels of insulin (5.37 ± 4.03

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Epicardial adipose tissue thickness and its association with adiponectin in metabolic syndrome patients from Mérida, Venezuela

Cited by 10 publications

References 28 publications

Association of serum concentrations of irisin and the adipokines adiponectin and leptin with epicardial fat in cardiovascular surgery patients

Association of serum concentrations of irisin and the adipokines adiponectin and leptin with epicardial fat in cardiovascular surgery patients

Effect of sitagliptin on epicardial fat thickness in subjects with type 2 diabetes and obesity: a pilot study

Response to the letter: Angiotensin-II induced insulin resistance

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