Elsevier

Clinical Biochemistry

Volumes 109–110, November–December 2022, Pages 44-50
Clinical Biochemistry

Association between circulating asprosin levels and carotid atherosclerotic plaque in patients with type 2 diabetes

https://doi.org/10.1016/j.clinbiochem.2022.04.018Get rights and content

Abstract

Background

Carotid plaque is one of the typical manifestations and precursors of diabetic cardiovascular complications. As a new adipokine, asprosin participates in the development of diabetes and cardiovascular diseases, and is considered to be closely related to insulin resistance and glucolipid metabolism. This study aimed to analyze the relationship between serum asprosin level and carotid plaque in patients with type 2 diabetes mellitus (T2DM).

Methods

A total of 180 patients with T2DM were selected. The basic parameters and biochemical indexes of the subjects were measured, and the serum asprosin concentration of the subjects was detected by ELISA. The carotid plaque was evaluated by color Doppler ultrasound.

Results

The level of serum asprosin in the T2DM with carotid plaque group was significantly higher than that in T2DM without carotid plaque group [2.53(1.73–3.21) vs 1.72(1.23–2.34) ng/mL, P < 0.05]. The incidence of carotid plaque in the low, middle and high quartiles was 31.7 %, 48.3 % and 70 % respectively. Correlation analysis showed that serum asprosin was positively correlated with BMI, WHR, SBP, DBP, FIns, LDL-C, HOMA-IR, and HOMA-β (P < 0.05). Linear regression analysis showed that WHR, DBP, FIns, and LDL-C were independent influencing factors of asprosin. Logistic regression analysis showed that serum asprosin was still significantly correlated with carotid plaque in T2DM patients after adjusting for multiple confounding factors. The area under receiver-operating curve (ROC) of asprosin predicting carotid plaque was 0.701 (0.625–0.777) in T2DM.

Conclusion

The level of serum asprosin in T2DM patients with carotid plaques is significantly higher, suggesting that asprosin may play a role in the occurrence and development of carotid plaques in T2DM. Detection of this index can provide new clinical evidence for the prevention and treatment of diabetic cardiovascular disease.

Introduction

Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disease with an increasing incidence worldwide [1]. With the development of the disease, the risk of microvascular and macrovascular complications in diabetic patients continues to increase [2]. Cardiovascular disease (CVD) is the representative macrovascular complications and the main cause of death in T2DM patients [3]. Therefore, the early prevention and diagnosis of diabetes and its macrovascular complications are particularly important. The occurrence of diabetic cardiovascular disease is a complex process involving multiple factors. Current studies have shown that its main pathophysiological mechanism is atherosclerosis [4], [5]. A large number of data shown that more than 75 % of T2DM patients have vascular atherosclerosis due to hyperglycemia, insulin resistance and hyperlipidemia, which increases the occurrence and development of macrovascular complications [3], [4]. It is generally believed that the pathogenesis of atherosclerosis was multifaceted. More and more studies have found that adipose tissue plays an important role in the occurrence and development of atherosclerosis [6]. In the past, we thought that adipose tissue was just an organ for storing energy. Recently, adipose tissue was supposed to be a major endocrine and paracrine organ, which can produce hundreds of protein molecules called “Adipokines” [7]. As enzymes, hormones, or growth factors, they participate in the regulation of insulin resistance and the metabolism of fat and glucose, and they have an indirect effect on atherosclerosis. In addition, they also directly affect endothelial function, vascular homeostasis and atherosclerosis [8], [9].

Adipokine is a kind of bioactive peptide/protein secreted by adipocytes. It plays a role not only in the energy metabolism, inflammation, and immune response, but also in the process of diabetes and obesity [10], [11], [12], [13]. Adipokines such as leptin, resistin and adiponectin could participate in the occurrence of diabetes and macrovascular complications by regulating insulin signaling and glucolipid metabolism [14], [15]. At present, the role of asprosin in the occurrence and development of diabetes is attracting more and more attention. Asprosin is composed of 140 amino acids. Exon 65 of FBN1 gene encodes 11 amino acids, and exon 66 encodes 129 amino acids, with a size of 30 kDa. Asprosin is a part of profibrillin protein, which is released by the C-terminal of profibrillin protein through specific protein hydrolysis [16], and is mainly expressed in white adipose tissue [16], [17]. Previous studies have found that asprosin was an adipokine very sensitive to energy state. It increased during fasting and decreased when eating [17]. In addition, after entering the circulatory system, asprosin acts on hepatocytes, skeletal muscle and islets, regulates glucose release, insulin secretion and insulin resistance, and finally increases blood glucose [17], [18], [19], [20], [21]. Asprosin can directly activate AgRP neurons through the blood–brain barrier by regulating cAMP-dependent pathway to induce eating and weight gain. It can also inhibit anorexic neuron pro-opiomelanocortin (POMC) and indirectly increase appetite, thus resulting in fat accumulation and weight gain [18], [22]. In conclusion, asprosin has the effect of increasing blood glucose and regulating lipid metabolism. It is closely related to insulin resistance and is an important factor affecting the occurrence and development of diabetic macroangiopathy [23], [24]. However, it is unclear whether circulating asprosin level is associated to the occurrence or development of arterial plaque. In this study, we aimed to explore the relationship between circulating asprosin and carotid plaques in patients with T2DM.

Section snippets

Subjects

The study was approved by the Biomedical Research Ethics Committee of the Affiliated Hospital of Jiangsu University, Jiangsu, China, and performed in accordance with the Declaration of Helsinki. Informed consent was obtained from each participant and all participants were treated in the Department of Endocrinology, Affiliated Hospital of Jiangsu University. A total of 180 T2DM subjects were recruited and completed a standard questionnaire, including lifestyle habits (smoking status, drinking

Clinical and biochemical features in T2DM with carotid plaque group and T2DM without carotid plaque group.

The clinical characteristics of the subgroups studied (T2DM with carotid plaque group and T2DM without carotid plaque group) are shown in Table 1. Compared with T2DM without carotid plaque group, the age, DM duration, SBP, HbA1c, 2hPG, creatinine, hypertension and statin use in T2DM with carotid plaque group were significantly increased (P < 0.05). Most importantly, the level of serum asprosin in T2DM with carotid plaque group was higher than that in T2DM without carotid plaque group

Logistic regression analysis for carotid plaques in T2DM patients

Logistic regression analysis (Table 5 unadjusted) showed that serum asprosin level in type 2 diabetic patients was independently associated with the occurrence of carotid plaques. Moreover, after adjusting different influencing factors, the level of serum asprosin was still closely related to the occurrence of carotid plaque (Table 5 model 1–3).

Discussion

In this study, we provide the evidence for the first time that the levels of serum asprosin were significantly elevated in T2DM patients with carotid plaque, and further ascended in obese patients. The correlation between serum asprosin and carotid plaque in T2DM patients still existed after adjusting for multiple metabolic confounding factors. These results suggested that asprosin may be involved in the occurrence and development of carotid plaque in T2DM patients.

Raised circulating asprosin

Conclusions

In summary, elevated serum asprosin in T2DM patients is a risk factor for carotid plaque, suggesting that asprosin may be involved in the occurrence and development of macrovascular disease in T2DM patients. However, the mechanism of its effect on macrovascular complications of type 2 diabetes needs to be further studied.

Funding

This work was supported by the National Natural Science Foundation of China (81870548), the Social Development Project of Jiangsu Province (BE2018692), the Natural Science Foundation of Jiangsu Province, China (BK20191222), Beigu talent cultivation program of Zhenjiang City, Jiangsu Province.(BGYCB202206), and the Fifth “169 project” Scientific Research Project of Zhenjiang City, Jiangsu Province.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgements

Not applicable.

Author contribution statement

All the authors of this manuscript have made substantial contributions to this work. GY and LY designed the study, drafted the manuscript. XD, ZC and LZ participated in the coordination of the whole work, analyzed data and writing manuscript. CW, DW, and YL interprets the data, revises the manuscript, and recruited participants and collected data. ZC, ZZ, HL, TG, and YX participated in acquisition of data and analyzed the data. All authors read and approved the final manuscript for publication.

Compliance with Ethical Standards

The study was approved by the Biomedical Research Ethics Committee of the Affiliated Hospital of Jiangsu University, Zhenjiang, China, and performed in accordance with the Declaration of Helsinki. All participants had informed consent to the purpose of the study.

Consent for publication

Not applicable.

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