Highlights
- •CEC is positively associated with total and HMW adiponectin, but not with chemerin or resistin.
- •Total adiponectin had the greatest association accounting for 8.3 % of the variance in CEC.
- •A synergistic interaction between adiponectin and chemerin was observed in raising efflux levels.
- •High CEC was associated with more favourable post-surgical outcomes.
Abstract
Aims
Cholesterol efflux capacity (CEC) as a measure of high-density lipoprotein functionality
is independently and inversely associated with increased risk of cardiovascular events
and mortality, and advanced plaque morphology. Adipokines, adipose tissue-derived
factors, can influence systemic lipoprotein metabolism, and participate in the regulation
of vascular function and inflammation. We aimed to investigate the association between
CEC and circulating adipokine levels (anti-inflammatory adiponectin, and pro-inflammatory
chemerin and resistin) in subjects with severe carotid atherosclerotic disease and
evaluate its impact on post-surgical outcomes.
Methods and results
This is a cross-sectional study with a 5-year follow-up component. Consecutive patients
with severe carotid atherosclerosis scheduled for a carotid endarterectomy were recruited
from hospital-based centres in Montreal, Canada (n = 285). Fasting blood samples were
collected pre-operatively and used to measure plasma total and high-molecular weight
(HMW) adiponectin, chemerin, and resistin, and to perform cholesterol efflux assays
in J774 macrophage-like cells. Five-year post-surgery outcomes were obtained through
medical chart review. Subjects had a mean age of 70.1 ± 9.4, were 67.0 % male, had
various comorbidities (hypercholesterolemia [85.3 %], hypertension [83.5 %], type
2 diabetes [34.5 %], coronary artery disease [38.6 %]), and previously experienced
cerebrovascular symptomatology (77.9 %). CEC was independently and positively associated
with total and HMW adiponectin levels (ß [95 % confidence interval]; 0.216 [0.134–0.298]
and 0.107 [0.037–0.176], respectively) but not with chemerin or resistin. Total adiponectin
had the greatest association accounting for 8.3 % of the variance in CEC. Interaction
regression models demonstrated a significant interaction between adiponectin and chemerin
in increasing CEC. Notably, with each unit increase in CEC there was a 93.9 % decrease
in the odds of having an ischemic cerebrovascular event 5 years post-surgery (0.061
[0.007–0.561]).
Conclusions
Our findings demonstrated circulating adiponectin to have a strong association with
increased CEC in subjects with severe carotid atherosclerosis and high CEC to be associated
with more favourable post-surgical outcomes. These findings reflect the importance
of adipose tissue health in influencing CEC levels and atherosclerotic cardiovascular
disease risk.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: December 21, 2022
Accepted:
December 16,
2022
Received:
September 19,
2022
Identification
Copyright
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