Apelin and its ratio to lipid factors are associated with cardiovascular diseases: A systematic review and meta-analysis

Abstract

Background The present systematic review and meta-analysis aimed to ascertain if the circulating levels of apelin, as an important regulator of the cardiovascular homeostasis, differ in patients with cardiovascular diseases (CVDs) and controls. Methods A comprehensive search was performed in electronic databases including PubMed, Scopus, EMBASE, and Web of Science to identify the studies addressing apelin in CVD up to April 5, 2021. Due to the presence of different units to measure the circulating levels of apelin across the included studies, they expressed the standardized mean difference (SMD) and their 95% confidence interval (CI) as summary effect size. A random-effects model comprising DerSimonian and Laird method was used to pool SMDs. Results Twenty-four articles (30 studies) comprised of 1793 cases and 1416 controls were included. Pooled results obtained through random-effects model indicated that apelin concentrations in the cases’ blood samples were significantly lower than those of the control groups (SMD = -0.72, 95% CI: -1.25, -0.18, P = 0.009; I2 = 97.3%, P<0.001). New combined biomarkers showed a significant decrease in SMD of apelin/high-density lipoprotein cholesterol (apelin/HDL-C) ratio [-5.17; 95% CI, -8.72, -1.63, P = 0.000; I2 = 99.0%], apelin/low-density lipoprotein cholesterol (apelin/LDL-C) ratio [-4.31; 95% CI, -6.08, -2.55, P = 0.000; I2 = 98.0%] and apelin/total cholesterol (apelin/TC) ratio [-17.30; 95% CI, -22.85, -11.76, P = 0.000; I2 = 99.1%]. However, no significant differences were found in the SMD of apelin/triacylglycerol (apelin/TG) ratio in cases with CVDs compared to the control group [-2.96; 95% CI, -7.41, 1.49, P = 0.000; I2 = 99.2%]. Conclusion The association of apelin with CVDs is different based on the region and disease subtypes. These findings account for the possible usefulness of apelin as an additional biomarker in the diagnosis of CVD in diabetic patients and in the diagnosis of patients with CAD. Moreover, apelin/HDL-c, apelin/LDL-c, and apelin/TC ratios could be offered as diagnostic markers for CVD.

Effects of flaxseed supplementation on weight loss, lipid profiles, glucose, and high‐sensitivity C‐reactive protein in patients with coronary artery disease: A systematic review and meta‐analysis of randomized controlled trials

“…Dyslipidemia is a condition that increases the risk for atherosclerosis and CAD, resulting in numerous fatalities globally. 32 We observed a notable decrease in circulating TG levels, suggesting the 33 also conducted a meta-analysis to determine the impact of flaxseed on blood levels of lipid markers in healthy and dyslipidemic individuals, demonstrating the same results as those obtained by Hadi et al 4 Similarly, Dodin et al 34 conducted a study that found that the daily consumption of 40 g of flaxseed led to improved lipid factor levels in healthy menopausal women after 12 months. However, another study indicated that the lipid profile did not exhibit any reduction after a 6-week period of consuming 15 mL/day of ALA flaxseed oil when compared to the consumption of olive oil during the same duration.…”

“…Dyslipidemia is a condition that increases the risk for atherosclerosis and CAD, resulting in numerous fatalities globally. 32 We observed a notable decrease in circulating TG levels, suggesting the potential cardioprotective properties of flaxseed oil. However, no alterations were observed in the other lipid parameters.…”

Evaluating Salivary Apelin Level among Chronic Periodontitis Patients, with and without Type 2 Diabetes Mellitus utilizing Enzyme‑Linked Immunosorbent Assay: A Comparative Study

“…Apelin has also been found to be crucial role in cardiac physiology concerningcontractility, vasodilation, and minimizing vascular wall inflammation 51 . A systematic review and meta-analysis conducted by Akbari H et al observed that the levels of apelin in patients with cardiovascular diseases were found to be significantly lower than the normal individuals 52 Apelin, a multisystem regulator peptide, modulates the function of cardiovascular, gastrointestinal, hypothalamus axis, and immune pathways. It also regulates the lipid metabolism and functioning of adipose tissue by enhancing the mRNA levels of uncoupling protein 1 (Ucp1), which is a marker of energy spending in brown adipose tissue, and mRNA levels of Uco3, which is a modulator of fatty acid transport in skeletal muscle 53,54 .…”

Chronic Low or High Nutrient Intake and Myokine Levels

“…Cholesterol intake was negatively associated with apelin and irisin levels, which improve carbohydrate and lipid metabolism, and have cardioprotection properties [ 8 , 32 , 36 , 37 ]. Runners with higher cholesterol intakes (>600 mg/day) had lower levels of irisin and apelin; moreover, runners with a lower fiber intake had lower levels of irisin.…”