Jia-Sian Hou

High Serum Adipocyte Fatty Acid Binding Protein Is Associated with Metabolic Syndrome in Patients with Type 2 Diabetes

Adipocyte fatty acid binding protein (A-FABP) is a key mediator of obesity-related metabolic syndrome (MetS). The aim of this study was to evaluate the relationship between A-FABP concentration and MetS in type 2 diabetes mellitus (DM) patients. Fasting blood samples were obtained from 165 type 2 DM volunteers. MetS and its components were defined using diagnostic criteria from the International Diabetes Federation. Among 165 DM patients, 113 patients (68.5%) had MetS. Diabetic persons who had MetS had significantly higher A-FABP levels (P < 0.001) than those without MetS. Female DM persons had higher A-FABP level than man (P < 0.001). No statistically significant differences in A-FABP levels were found in use of statin, fibrate, or antidiabetic drugs. Multivariate forward stepwise linear regression analysis revealed that body fat mass (P < 0.001), logarithmically transformed creatinine (log-creatinine; P < 0.001), female DM patients (P < 0.001), and logarithmically transformed high sensitive C-reactive protein (log-hs-CRP; P = 0.013) were positively correlated, while albumin (P = 0.004) and glomerular filtration rate (GFR; P = 0.043) were negatively correlated with serum A-FABP levels in type 2 DM patients. In this study, higher serum A-FABP level was positively associated with MetS in type 2 DM patients.

High serum leptin level is associated with peripheral artery disease in adult peritoneal dialysis patients

Objective: Peripheral artery disease (PAD) is associated with systemic atherosclerosis and indicates an increased risk of mortality in peritoneal dialysis (PD) patients. A high leptin level accelerates atherosclerosis in apoE-deficient mice. The purpose of this study was to examine the association of serum leptin level and PAD in adult PD patients. Materials and Methods: The clinical characteristics of sixty PD patients recruited from June 2015 to October 2016 were obtained. Serum leptin concentrations were determined. Ankle–brachial index (ABI) values were measured and those with a left or right ABI <0.9 were defined as the low ABI group. Results: Twenty of these 60 PD patients (33.3%) had diabetes mellitus and 32 patients (53.3%) had hypertension. Thirteen PD patients (21.7%) were in the low ABI group. Higher serum leptin (P = 0.002) and C-reactive protein (CRP, P < 0.001) levels were found in the low ABI group compared with those in the normal ABI group. More number of patients with diabetes (P = 0.015) and current smokers (P = 0.037) were noted in the low ABI group than in the normal ABI group. After adjustment for factors that were significantly associated with PAD in multivariate logistic regression analysis, each increase of 1 ng/mL in the serum leptin level (odds ratio [OR], 1.062; 95% confidence interval [CI], 1.014–1.114; P = 0.012) and each increase of 0.1 mg/dL in the serum CRP level (OR, 1.107; 95% CI, 1.011–1.211; P = 0.028) were found to be independent predictors of PAD in PD patients. Conclusion: Higher serum leptin and CRP levels correlated positively with the diagnosis of PAD in PD patients.

Positive correlation of serum leptin levels and peripheral arterial stiffness in patients with type 2 diabetes

Objective: Leptin plays a pathophysiologic role in the pathogenesis of aortic dysfunction and peripheral arterial stiffness (PAS). Our aim was to evaluate the risk factors for developing PAS and the association of leptin and PAS in patients with type 2 diabetes mellitus (DM). Materials and Methods: Fasting blood samples were obtained for biochemical data and leptin determinations from 105 patients with type 2 DM. In this study, we applied an automatic pulse wave analyzer (VaSera VS-1000) to measure the brachial-ankle pulse wave velocity (baPWV); a baPWV value >14.0 m/s on either side was considered high PAS. Results: Seventy-five patients (71.4%) had high PAS and they included a higher percentage of patients with hypertension (P < 0.001), older age (P < 0.001), and a higher body fat mass (P = 0.043), systolic blood pressure (P < 0.001), diastolic blood pressure (P = 0.016), serum blood urea nitrogen (P = 0.003), and leptin level (P < 0.001), and lower height (P = 0.027) and glomerular filtration rate (P < 0.001) compared with type 2 DM patients with low PAS. After adjusting for factors significantly associated with PAS in these patients by multivariate logistic regression analysis, age (β = 0.470, adjusted R2 change = 0.279; P < 0.001), logarithmically transformed leptin (log-leptin, β = 0.259, adjusted R2 change = 0.085; P = 0.001), and hypertension (β = 0.197, adjusted R2 change = 0.031; P = 0.011) were significant independent predictors of PAS in type 2 DM patients. Conclusion: The serum leptin level could be a predictor of PAS in type 2 DM patients.

A Cross-Sectional Prospective Study of Low Serum L-carnitine Level Associated with Peripheral Arterial Stiffness in Renal Transplant Recipients

Introduction L-carnitine is an important co-factor in fatty acid metabolism by mitochondria and L-carnitine deficiency is associated with insulin resistance. Insulin resistance is an independent association with arterial stiffness. The present study evaluated the relationship between fasting serum L-carnitine level and peripheral arterial stiffness (PAS) in renal transplant recipients. Materials and Methods Fasting blood samples were collected from 65 renal transplant recipients. In this study, we applied an automatic pulse wave analyzer (VaSera VS-1000) to measure the brachial-ankle pulse wave velocity (baPWV), A baPWV value greater than 14.0 m/s on either side was considered high PAS. Serum L-carnitine was performed with high-performance liquid chromatography and mass spectrometry. Results Thirty-six renal transplant recipients (55.4%) had high PAS, and they included a higher percentage of patients with diabetes (P = 0.001), hypertension (P = 0.033), metabolic syndrome (P = 0.044), older age (P < 0.041), and a higher renal transplant duration (P = 0.025), waist circumference (P = 0.010), systolic blood pressure (P = 0.002), serum triglyceride (P = 0.040), insulin (P = 0.002), and homeostasis model assessment of insulin resistance (HOMA-IR, P = 0.002), while lower high-density lipoprotein cholesterol (P = 0.036), and serum L-carnitine levels (P < 0.001) compared with renal transplant recipients without PAS. After adjusting for factors significantly associated with PAS in these patients by multivariate logistic regression analysis, renal transplant duration (Odds ratio (OR): 1.028, 95% confidence interval (CI): 1.003–1.054, P = 0.029) and serum L-carnitine levels (OR: 0.916, 95% CI: 0.842–0.998, P = 0.044) was independently associated with PAS in renal transplant recipients. The area under the receiver-operating characteristic (ROC) curve indicates the diagnostic power of L-carnitine at predicting PAS of renal transplant recipients was 0.789 (95% CI: 0.670-0.881, P < 0.001). Conclusion The serum fasting L-carnitine level is negatively associated with PAS in renal transplant patients. Figure. No caption available.

Serum cystatin C is independently associated with aortic arterial stiffness in patients with type 2 diabetes

BACKGROUND Higher cystatin C levels are associated with an increased cardiovascular risk. We evaluated the association between serum cystatin C and aortic arterial stiffness in patients with type 2 diabetes mellitus (DM). METHODS Fasting blood samples were collected from 170 patients with type 2 DM. Carotid-femoral pulse wave velocity (cfPWV) values > 10 m/s were used to define the high aortic arterial stiffness group. RESULTS Sixty-seven patients with DM (39.4%) were defined as the high aortic arterial stiffness group. Patients with DM in the high aortic arterial stiffness group had older age (P = 0.003), higher systolic blood pressure (P < 0.001), diastolic blood pressure (P = 0.045), triglyceride (P = 0.046), blood urea nitrogen (P = 0.038), creatinine (P = 0.006), urine albumin-to-creatinine ratio (P = 0.004), and serum cystatin C (P < 0.001) levels but lower estimated glomerular filtration rate (P < 0.001). Multivariate logistic regression analysis showed that serum cystatin C level (each increase of 0.1 mg/l, odds ratio: 1.369, 95% confidence interval (CI): 1.049-1.787, P = 0.021) was still an independent predictor of aortic arterial stiffness in patients with DM. CONCLUSION Serum cystatin C level positively correlated with aortic arterial stiffness among patients with type 2 DM.

Negative Correlation of Serum Adiponectin Levels With Carotid–Femoral Pulse Wave Velocity in Patients Treated With Hemodialysis

Purpose: The aim of this study was to evaluate the relationship between serum adiponectin levels and carotid–femoral pulse wave velocity (cfPWV) in hemodialysis (HD) patients. Method: Blood samples were obtained from 120 HD patients. cfPWV was measured with a validated tonometry system (SphygmoCor; AtCor Medical, West Ryde, Australia). Serum adiponectin levels were measured using a commercially available enzyme-linked immunosorbent assay kit. Results: By univariate linear analysis of cfPWV in HD patients, we found that diabetes (r = .281, p = .002), pre-HD body weight (r = .194, p = .033), post-HD body weight (r = .192, p = .036), waist circumference (r =.210, p = .022), and body fat mass (r = .194, p = .034) were positively correlated, whereas adiponectin level (r = −.254, p = .005) was negatively correlated with cfPWV in HD patients. Multivariate forward stepwise linear regression analysis showed that diabetes (β = .274, p = .006) and adiponectin level (β = −.215, p = .016) were independent predictors of cfPWV in HD patients. Moreover, post-HD body weight (β = −.274, p = .041), waist circumference (β = −.311, p < .001), logarithmically transformed triglyceride level (log-TG; β = −.186, p = .031), and log-glucose (β = −.225, p = .008) were negatively associated with adiponectin levels in HD patients after multivariable forward stepwise linear regression analysis. Conclusions: Among HD patients, serum adiponectin level was inversely associated with cfPWV level, and post-HD body weight, waist circumference, log-TG, and log-glucose were negatively associated with adiponectin level.