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2 . 2022

Epicardial fat and the activity of proinflammatory cytokines and adipokines in individuals with unstable angina and metabolic disorders

Abstract

The study of the role of epicardial fat in maintaining the activity of the inflammatory process in patients with unstable angina and metabolic syndrome appears especially relevant today.

The aim of the study was to identify the correlation between the severity of epicardial fat in individuals with unstable angina and metabolic dysfunction with the secretion of proinflammatory cytokines and adipokines.

Material and methods. 102 patients were examined, average age 61.2±7.6 years, medium or high risk on the Grace 2.0 scale. The examination included a survey, assessing standard laboratory parameters, as well as levels of leptin, adiponectin, TNF-α and IL‑6, analysis of anthropometric data and body composition, including the content of total and visceral fat in the body (%). Echocardiographic examination was carried out 2–4 days after hospitalization in accordance with the standard protocol. Epicardial fat was measured from the parasternal position along the long and short axis of the left ventricle at the end of the systole for 3 consecutive cycles, the average of the following three values was taken as the thickness of epicardial fat. Percutaneous coronary intervention and stenting of one or more arteries was performed on the 1st‑3rd day from the moment of hospitalization. The patients were divided into 2 groups depending on the thickness of epicardial adipose tissue (EAT): 1st group with EAT up to 7.6 mm (n=46); 2nd – ​EAT >7.6 mm (n=56).

Results. There were no significant differences between the groups according to the main anthropometric indicators, however, a significant increase in visceral fat was registered in the 2nd group [13 (11–15.5); 14.25 (12.5–18), p=0.017] and total adipose tissue [29.7±8.3 (27.2–32.1) 34.2±6.5 (32.5–36), p=0.008]. Analysis of laboratory parameters revealed a significant increase in TNF-α levels in the 2nd group by 12.6 (12.1–13.6) vs 12.1 (11.8–12.6) pg/mL (p=0.001) and IL‑6 levels by 3.4 (2.8–5.6) vs 2.1 (1.1–2.4) pg/mL (p<0.001). The concentration of leptin was also significantly higher in the 2nd group, 19 (13.1–32) vs 13.4 (7–28.1) μg/mL (p=0.005), and the level of adiponectin in the 1st group was 5.4 (4.2–11.4) μg/mL vs 5.1 (3–6.4) μg/mL (p=0.019). In the 2nd group, there was a noticeable positive correlation between the EAT and the IL‑6 level (Spearman's rank correlation coefficient r=634; p>0.001) and moderate positive correlation between the EAT and the TNF-α level (r=326; p=0.001).

Conclusion. The thickness of epicardial fat in individuals with unstable angina and metabolic disorders is associated with the activity of proinflammatory cytokines. Disorders of leptin and adiponectin secretion in patients with unstable angina and metabolic disorders are more closely related to the thickness of epicardial fat than to the total volume of adipose tissue and other anthropometric indicators.

Keywords:epicardial adipose tissue; metabolic syndrome; adiponectin; leptin; proinflammatory cytokines; unstable angina

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

Contribution. Conception, data collection, analysis, statistical analysis, manuscript writing, final approval – ​Davydova A.V.; conception, analysis, manuscript writing, final approval – ​Nikiforov V.S., Khalimov Yu.Sh. All the authors contributed significantly to the study and the article, read and approved the final version of the article before publication.

For citation: Davydova A.V., Nikiforov V.S., Khalimov Yu.Sh. Epicardial fat and the activity of proinflammatory cytokines and adipokines in individuals with unstable angina and metabolic disorders. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2022; 11 (2): 27–33. DOI: https://doi.org/10.33029/2304-9529-2022-11-2-27-33 (in Russian)

REFERENCES

1. Wu Y., Zhang A., Hamilton D.J., Deng T. Epicardial fat in the maintenance of cardiovascular health. Methodist Debakey Cardiovasc J. 2017; 13 (1): 20–4. DOI: https://doi.org/10.14797/mdcj-13-1-20

2. Davydova A.V., Nikiforov V.S, Khalimov Yu.S. Thickness of epicardial adipose tissue as a predictor of cardiovascular risk. Consilium Medicum. 2018; 20 (10): 91–4. DOI: https://doi.org/10.26442/2075-1753_2018.10.91-94 (in Russian)

3. Villasante Fricke A.C., Iacobellis G. Epicardial adipose tissue: clinical biomarker of cardio-metabolic risk. Int J Mol Sci. 2019; 20 (23): 5989. DOI: https://doi.org/10.3390/ijms20235989; PMID: 31795098; PMCID: PMC 6929015.

4. Iacobellis G., Assael F., Ribaudo M.C., Zappaterreno A., Alessi G., Di Mario U., et al. Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obes Res. 2003; 11 (2): 304–10. DOI: https://doi.org/10.1038/oby.2003.45; PMID: 12582228.

5. Berg G., Miksztowicz V., Morales C., Barchuk M. Epicardial adipose tissue in cardiovascular disease. Adv Exp Med Biol. 2019; 1127: 131–43. DOI: https://doi.org/10.1007/978-3-030-11488-6_9; PMID: 31140176.

6. Zhao S., Kusminski C.M., Scherer P.E. Adiponectin, leptin and cardiovascular disorders. Circ Res. 2021; 128 (1): 136–49. DOI: https://doi.org/10.1161/CIRCRESAHA.120.314458; PMID: 33411633; PMCID: PMC 7799441.

7. Russo R., Di Iorio B., Di Lullo L., Russo D. Epicardial adipose tissue: new parameter for cardiovascular risk assessment in high-risk populations. J Nephrol. 2018; 31 (6): 847–53. DOI: https://doi.org/10.1007/s40620-018-0491-5; PMID: 29704210.

8. Collet J., Thiele H., et al.; ESC Scientific Document Group. 2020 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021; 42 (14): 1289–367.

9. Barbarash O.L., Duplyakov D.V., Zateyshchikov D.A., Panchenko E.P., et al. 2020 Clinical practice guidelines for Acute coronary syndrome without ST segment elevation. Rossiyskiy kardiologicheskiy zhurnal [Russian Journal of Cardiology]. 2021; 26 (4): 149–202. DOI: https://doi.org/10.15829/1560-4071-2021-4449 (in Russian)

10. Nikolaev D.V., Rudnev S.G. Bioimpedance analysis: fundamentals of the method, examination protocol and interpretation of the results. Sportivnaya meditsina: nauka i praktika [Sports Medicine: Science and Practice]. 2012; (2): 29–37. (in Russian)

11. Iacobellis G., Willens H.J. Echocardiographic epicardial fat: a review of research and clinical applications. J Am Soc Echocardiogr. 2009; 22 (12): 1311–9. DOI: https://doi.org/10.1016/j.echo.2009.10.013; PMID: 19944955.

12. Koepp K., Obokata M., Reddy Y., Olson T., Borlaug B. Hemodynamic and functional impact of epicardial adipose tissue in heart failure with preserved ejection fraction. JACC Heart Fail. 2020; 8 (8): 657–66. DOI: https://doi.org/10.1016/j.jchf.2020.04.016

13. Holmes C, Racette S. The utility of body composition assessment in nutrition and clinical practice: an overview of current methodology. Nutrients. 2021; 13 (8): 2493. DOI: https://doi.org/10.3390/nu13082493; PMID: 34444653; PMCID: PMC 8399582.

14. Villasante Fricke A.C., Iacobellis G. Epicardial adipose tissue: clinical biomarker of cardio-metabolic risk. Int J Mol Sci. 2019; 20 (23): 5989. DOI: https://doi.org/10.3390/ijms20235989; PMID: 31795098; PMCID: PMC 6929015.

15. Li X., Zhai Y., Zhao J., He H., Li Y., Liu Y., et al. Impact of metabolic syndrome and it’s components on prognosis in patients with cardiovascular diseases: a meta-analysis. Front Cardiovasc Med. 2021; 8: 704145. DOI: https://doi.org/10.3389/fcvm.2021.704145; PMID: 34336959; PMCID: PMC 8319572.

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CHIEF EDITOR
CHIEF EDITOR
Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)
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