title: The relationship of novel adipokines, RBP4 and omentin-1, with carotid atherosclerosis severity and vulnerability.
abstract: OBJECTIVE
  We investigated the relationship of circulating novel adipokines, retinol-binding protein 4 (RBP4) and omentin-1, with advanced carotid atherosclerosis and ultrasound indexes of severity (total plaque area-TPA) and plaque echogenicity and vulnerability (Gray-Scale median - GSM score).
  
  
  METHODS
  We enrolled 225 patients with high-grade carotid stenosis (HGCS) who underwent carotid revascularization (73 Symptomatic patients, 152 asymptomatic patients) and 75 age- and sex-matched, asymptomatic individuals with low-grade (<50%) carotid stenosis (LGCS). Seventy-three individuals without current manifestations of atherosclerotic disease served as control group (COG). All participants underwent carotid ultrasound with TPA and GSM score assessment. Moreover, clinical parameters, metabolic profile, and circulating levels of hsCRP and adipokines were assessed.
  
  
  RESULTS
  RBP4 was significantly elevated in HGCS (51.44 ± 16.23 mg/L) compared to LGCS (38.39 ± 8.85 mg/L), independent of symptoms existence, whereas RBP4 levels in COG were even lower (25.74 ± 10.72 mg/L, p < 0.001 compared to either HGCS or LGCS). Inversely, serum omentin-1 levels were significantly lower across HGCS (490.41 ± 172 ng/ml) and LGCS (603.20 ± 202.43 ng/ml) than COG (815.3 ± 185.32, p < 0.001). Moreover, the considerable difference between HGCS and LGCS (p < 0.001) was exclusively attributed to the excessive suppression of omentin-1 concentrations in symptomatic versus asymptomatic (p = 0.004) patients. HGCS and LGCS did not differ in the rest of clinical and biochemical parameters. In multiple regression analysis, RBP4 (beta = 0.232, p = 0.025) and hsCRP (beta = 0.300, p = 0.004) emerged as independent determinants of TPA in patients with carotid atherosclerosis. Low serum levels of omentin-1 correlated with GSM score and symptoms but that association was lost in multivariate analysis..
  
  
  CONCLUSIONS
  RBP4 serum levels were significantly elevated in patients with established carotid atherosclerosis and were positively associated with atherosclerosis severity. The association of low serum omentin-1 with carotid plaque echolucency requires further investigation.. ClinicalTrials.gov Identifier: NCT00636766.
authors: Department of Vascular Surgery, Medical School, "Attikon" University General Hospital, Athens, Greece. Electronic address: nikoskad@yahoo.com.
authors: Nikolaos P E
authors: NP
authors: Kadoglou
authors: 2nd Department of Internal Medicine, Research Institute and Diabetes Centre, Athens University Medical School, "Attikon" University General Hospital, Athens, Greece.
authors: Vaia
authors: V
authors: Lambadiari
authors: School of Electrical and Computer Engineering, National Technical University of Athens, Greece.
authors: Aimilia
authors: A
authors: Gastounioti
authors: Department of Vascular Surgery, Medical School, "Attikon" University General Hospital, Athens, Greece.
authors: Christos
authors: C
authors: Gkekas
authors: Department of Vascular Surgery, Medical School, "Attikon" University General Hospital, Athens, Greece.
authors: Triantafyllos G
authors: TG
authors: Giannakopoulos
authors: Department of Vascular Surgery, Medical School, "Attikon" University General Hospital, Athens, Greece.
authors: Katerina
authors: K
authors: Koulia
authors: 2nd Department of Internal Medicine, Research Institute and Diabetes Centre, Athens University Medical School, "Attikon" University General Hospital, Athens, Greece.
authors: Eirini
authors: E
authors: Maratou
authors: Department of Cytopathology, "Attikon" University General Hospital, Athens, Greece.
authors: Maria
authors: M
authors: Alepaki
authors: Department of Vascular Surgery, Medical School, "Attikon" University General Hospital, Athens, Greece.
authors: John
authors: J
authors: Kakisis
authors: Department of Cytopathology, "Attikon" University General Hospital, Athens, Greece.
authors: Petros
authors: P
authors: Karakitsos
authors: School of Electrical and Computer Engineering, National Technical University of Athens, Greece.
authors: Konstantina S
authors: KS
authors: Nikita
authors: 2nd Department of Internal Medicine, Research Institute and Diabetes Centre, Athens University Medical School, "Attikon" University General Hospital, Athens, Greece.
authors: George
authors: G
authors: Dimitriadis
authors: Department of Vascular Surgery, Medical School, "Attikon" University General Hospital, Athens, Greece.
authors: Christos D
authors: CD
authors: Liapis
mesh_terms: D002097:C-Reactive Protein / Q000378:metabolism; D002340:Carotid Artery Diseases / Q000097:blood / Q000473:pathology*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000473:pathology*; D016207:Cytokines / Q000097:blood*; D058851:GPI-Linked Proteins / Q000097:blood; D006801:Humans; D037102:Lectins / Q000097:blood*; D058226:Plaque, Atherosclerotic / Q000473:pathology; D054839:Retinol-Binding Proteins, Plasma / Q000378:metabolism*; D014463:Ultrasonography
chemical_list: D016207:Cytokines; D058851:GPI-Linked Proteins; C432397:ITLN1 protein, human; D037102:Lectins; C101326:RBP4 protein, human; D054839:Retinol-Binding Proteins, Plasma; D002097:C-Reactive Protein
keywords: Adipokines; Carotid atherosclerosis; Omentin-1; Retinol-binding protein-4; Stroke