title: The role of mediastinal adipose tissue 11β-hydroxysteroid d ehydrogenase type 1 and glucocorticoid expression in the development of coronary atherosclerosis in obese patients with ischemic heart disease.
abstract: BACKGROUND
  Visceral fat deposition and its associated atherogenic complications are mediated by glucocorticoids. Cardiac visceral fat comprises mediastinal adipose tissue (MAT) and epicardial adipose tissue (EAT), and MAT is a potential biomarker of risk for obese patients.
  
  
  OBJECTIVE
  Our objective was to evaluate the role of EAT and MAT 11beta-hydroxysteroid dehydrogenase type 1 (11β-HSD-1) and glucocorticoid receptor (GCR) expression in comparison with subcutaneous adipose tissue (SAT) in the development of coronary atherosclerosis in obese patients with coronary artery disease (CAD), and to assess their correlations with CD68 and fatty acids from these tissues.
  
  
  RESULTS
  Expression of 11β-HSD-1 and GCR was measured by qRT-PCR in EAT, MAT and SAT of thirty-one obese patients undergoing coronary artery bypass grafting due to CAD (obese CAD group) and sixteen obese patients without CAD undergoing heart valve surgery (controls). 11β-HSD-1 and GCR expression in MAT were found to be significantly increased in the obese CAD group compared with controls (p < 0.05). In the obese CAD group, 11β-HSD-1 and GCR mRNA levels were strongly correlated in MAT. Stearidonic acid was significantly increased in EAT and MAT of the obese CAD group and arachidonic acid was significantly expressed in MAT of the obese male CAD group (p < 0.05).
  
  
  CONCLUSIONS
  We report for the first time the increased expression of 11β-HSD-1 and GCR in MAT compared with EAT and SAT, and also describe the interrelated effects of stearidonic acid, HOMA-IR, plasma cortisol and GCR mRNA levels, explaining 40.2% of the variance in 11β-HSD-1 mRNA levels in MAT of obese CAD patients. These findings support the hypothesis that MAT contributes locally to the development of coronary atherosclerosis via glucocorticoid action.
authors.affiliation: Department Growth-Development and Pediatric Endocrinology, Child Health Institute, Istanbul University, Istanbul, Turkey. tmatalar@yahoo.com
authors.forename: Fatmahan
authors.initials: F
authors.lastname: Atalar
authors.forename: Selcuk
authors.initials: S
authors.lastname: Gormez
authors.forename: Baris
authors.initials: B
authors.lastname: Caynak
authors.forename: Gokce
authors.initials: G
authors.lastname: Akan
authors.forename: Gamze
authors.initials: G
authors.lastname: Tanriverdi
authors.forename: Sema
authors.initials: S
authors.lastname: Bilgic-Gazioglu
authors.forename: Demet
authors.initials: D
authors.lastname: Gunay
authors.forename: Cihan
authors.initials: C
authors.lastname: Duran
authors.forename: Belhhan
authors.initials: B
authors.lastname: Akpinar
authors.forename: Ugur
authors.initials: U
authors.lastname: Ozbek
authors.forename: Ahmet Sevim
authors.initials: AS
authors.lastname: Buyukdevrim
authors.forename: Zeliha
authors.initials: Z
authors.lastname: Yazici
mesh_terms: D043205:11-beta-Hydroxysteroid Dehydrogenase Type 1 / Q000032:analysis* / Q000235:genetics; D000368:Aged; D015703:Antigens, CD / Q000032:analysis; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis; D016718:Arachidonic Acid / Q000032:analysis; D016022:Case-Control Studies; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000201:enzymology* / Q000235:genetics / Q000601:surgery; D015525:Fatty Acids, Omega-3 / Q000032:analysis; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D050152:Intra-Abdominal Fat / Q000201:enzymology*; D016014:Linear Models; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000201:enzymology* / Q000235:genetics; D009765:Obesity / Q000201:enzymology*; D012333:RNA, Messenger / Q000032:analysis; D011965:Receptors, Glucocorticoid / Q000032:analysis* / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D050151:Subcutaneous Fat / Q000201:enzymology; D000097382:CD68 Molecule
chemical_list: D043205:11-beta-Hydroxysteroid Dehydrogenase Type 1; D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D016718:Arachidonic Acid; D015525:Fatty Acids, Omega-3; D006854:Hydrocortisone; D012333:RNA, Messenger; D011965:Receptors, Glucocorticoid; C067980:CD68 antigen, human; D000097382:CD68 Molecule; C468386:HSD11B1 protein, human; C062895:stearidonic acid