Association between serum adipsin and plaque vulnerability determined by optical coherence tomography in patients with coronary artery disease

Renhua Sun; Yong Qiao; Gaoliang Yan; Dong Wang; Wenjie Zuo; Zhenjun Ji; Xiaoguo Zhang; Yuyu Yao; Genshan Ma; Chengchun Tang

doi:10.21037/jtd-21-259

Association between serum adipsin and plaque vulnerability determined by optical coherence tomography in patients with coronary artery disease

J Thorac Dis. 2021 Apr;13(4):2414-2425. doi: 10.21037/jtd-21-259.

Authors

Renhua Sun^{1

2}, Yong Qiao¹, Gaoliang Yan¹, Dong Wang¹, Wenjie Zuo¹, Zhenjun Ji¹, Xiaoguo Zhang¹, Yuyu Yao¹, Genshan Ma¹, Chengchun Tang¹

Affiliations

¹ Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
² Department of Cardiology, Yancheng No.1 People's Hospital, Yancheng, China.

Abstract

Background: Early identification of vulnerable plaques is important for patients with coronary artery disease (CAD) to reduce acute coronary events and improve their prognosis. We sought to examine the relationship between adipsin, an adipokine secreted from adipocytes, and plaque vulnerability in CAD patients.

Methods: A total of 103 plaques from 99 consecutive patients who underwent coronary angiography were assessed by optical coherence tomography. The serum level of adipsin was measured using enzyme-linked immunosorbent assay (ELISA). The accuracy of adipsin for detecting thin-cap fibroatheroma (TCFA) was determined by the area under the receiver operating characteristic curve (AUC).

Results: Of the 99 patients, 49 were classified into the low adipsin group and 50 into the high adipsin group according to the median level of serum adipsin (2.43 µg/mL). The plaques from the high adipsin group exhibited a greater lipid index (2,700.0 vs. 1,975.9° × mm, P=0.015) and an increased proportion of TCFAs (41.2% vs. 21.2%, P=0.028) compared with the low adipsin group. Serum adipsin was found to be negatively correlated with fibrous cap thickness (ρ=-0.322, P=0.002), while it was positively correlated with average lipid arc (ρ=0.253, P=0.015), maximum lipid arc (ρ=0.211, P=0.044), lipid core length (ρ=0.241, P=0.021), lipid index (ρ=0.335, P=0.001), and vulnerability score (ρ=0.254, P=0.014). Furthermore, adipsin had a significant association with TCFAs (OR: 1.290, 95% CI: 1.048-1.589, P=0.016) in the multivariate analysis, while having a moderate diagnostic accuracy for TCFAs (AUC: 0.710, 95% CI: 0.602-0.817, P<0.001).

Conclusions: Our findings suggest that serum adipsin is significantly and positively correlated with the incidence of TCFAs. The application of adipsin as a biomarker may offer improvement in the diagnosis of vulnerable plaques and clinical benefits for CAD patients.

Keywords: Adipsin; coronary artery disease (CAD); optical coherence tomography; plaque vulnerability; thin-cap fibroatheroma (TCFA).