ASSOCIATION OF CIRCULATING RESISTIN LEVELS WITH INFLAMMATORY MARKERS, GLYCEMIC AND LIPID INDICES IN PEOPLE WITH OBESITY, MORBID OBESITY AND LEAN PAKISTANI SUBJECTS

Main Article Content

Bashir Ahmed Shaheen
Dr. Ziaur Rahman
Dr. Muhammad Afzal

Keywords

Hyperresistinemia, Interleukin-6, Insulin resistance, HDL, Diabetes, Central Obesity

Abstract

Obesity is a multisystem disorder and is strongly associated with metabolic impairments. Obesity is characterized by a state of altered adipose tissue functions with low-grade inflammation, insulin insensitivity and dyslipidemia. The current study aimed to explore the correlation of circulatory resistin with metabolic and inflammatory markers in adults with obesity and healthy lean Pakistani subjects. This study was carried out on 622 Pakistani subjects and anthropometric and clinical parameters were assessed, which include BMI, WHR, blood pressure manually, while resistin, insulin, inflammatory markers by enzyme-linked immunosorbent assay technique (ELISA), and lipids, and glycemic indices using the chemistry analyzer Microlab-300XL.


The analysis revealed that overall circulating resistin was markedly elevated in all categories of obesity as compared to lean, healthy subjects (P<0.001).The resistin outcomes were found to be strongly associated with obesity indices (BMI, r = 0.669 and P<0.001), central adiposity indices (hip, waist, and WHR, r = 0.669 and P<0.001), systolic and diastolic blood pressure (r=0.61, r = 0.625 and P<0.001), HOMA-IR (r = 0.763, and P<0.001), lipid indices (cholesterol with r = 0.759, TGs with r = 0.755 and HDL, r =-0.749 with P< 0.001) and IL-6 with r = 0.849, CRP, r = 0.829 and TNF-α, r =-0.812 with P< 0.001) among lean controls versus metabolically healthy, metabolically unhealthy, and  subjects with obesity and diabetes. The serum resistin level was taken as dependent variable by the reduced model of multiple linear regression presented a highly significant association between elevated resistin and MHO, MUO, and DO (with p<0.001 and all other factors were considered insignificant in this background removal method.


In conclusion the current study uncovered that hyperresistinemia is an important indicator of several health issues, including metabolic dysregulation, insulin resistance, low-grade inflammation, obesity, and type 2 diabetes. These findings underscore the importance of proactive measures to effectively prevent and manage these conditions.

Abstract 55 | pdf Downloads 34

References

1. Galindo RJ, Uppal TS, McCoy RG, Umpierrez GE, Ali MK. Use and continuity of weight-modifying medications among adults with diabetes and overweight/obesity: US population study. Obesity (Silver Spring, Md). 2023.
2. Kansra AR, Lakkunarajah S, Jay MS. Childhood and adolescent obesity: A review. Frontiers in pediatrics. 2021;8:866.
3. Alemán JO, Almandoz JP, Frias JP, Galindo RJ. Obesity among Latinx people in the United States: A review. Obesity. 2023;31(2):329-37.
4. Haththotuwa RN, Wijeyaratne CN, Senarath U. Worldwide epidemic of obesity. Obesity and obstetrics: Elsevier; 2020. p. 3-8.
5. Laar RA, Shi S, Ashraf MA, Khan MN, Bibi J, Liu Y. Impact of physical activity on challenging obesity in Pakistan: a knowledge, attitude, and practice (KAP) study. International journal of environmental research and public health. 2020;17(21):7802.
6. Tariq S, Tariq S, Tariq S, Rehman R. Relationship of BMI with Junk Food, sleep pattern, exam performance and awareness about its ill health effects in healthy teenagers. JPMA The Journal of the Pakistan Medical Association. 2021;71(1 (A)):59.
7. Shahid SU, Hasnain S. Identification of genetic basis of obesity and mechanistic link of genes and lipids in Pakistani population. Bioscience reports. 2018;38(4):BSR20180281.
8. Buitinga M, Veeraiah P, Haans F, Schrauwen‐Hinderling VB. Ectopic lipid deposition in muscle and liver, quantified by proton magnetic resonance spectroscopy. Obesity. 2023.
9. James DE, Stöckli J, Birnbaum MJ. The aetiology and molecular landscape of insulin resistance. Nature Reviews Molecular Cell Biology. 2021;22(11):751-71.
10. Ghosh AR, Bandopadhyay P, Sarkar J, Khanna S, Chaudhuri T, Tantia O, et al. Mitochondrial sourcing of interferogenic ligands and an autoantigen in human obesity‐associated metaflammation. Obesity. 2023.
11. Steppan CM, Bailey ST, Bhat S, Brown EJ, Banerjee RR, Wright CM, et al. The hormone resistin links obesity to diabetes. Nature. 2001;409(6818):307-12.
12. Su K-z, Li Y-r, Zhang D, Yuan J-h, Zhang C-s, Liu Y, et al. Relation of circulating resistin to insulin resistance in type 2 diabetes and obesity: a systematic review and meta-analysis. Frontiers in physiology. 2019;10:1399.
13. De Luis D, Sagrado MG, Conde R, Aller R, Izaola O, Primo D. Lack of association of serum resistin levels with metabolic syndrome criteria in obese female patients. Clinical biochemistry. 2011;44(16):1280-3.
14. Kocot J, Dziemidok P, Kiełczykowska M, Hordyjewska A, Szcześniak G, Musik I. Adipokine profile in patients with type 2 diabetes depends on degree of obesity. Medical science monitor: international medical journal of experimental and clinical research. 2017;23:4995.
15. Liu W, Zhou X, Li Y, Zhang S, Cai X, Zhang R, et al. Serum leptin, resistin, and adiponectin levels in obese and non-obese patients with newly diagnosed type 2 diabetes mellitus: a population-based study. Medicine. 2020;99(6):e19052.
16. Zatterale F, Longo M, Naderi J, Raciti GA, Desiderio A, Miele C, et al. Chronic adipose tissue inflammation linking obesity to insulin resistance and type 2 diabetes. Frontiers in physiology. 2020;10:1607.
17. Iacobini C, Pugliese G, Fantauzzi CB, Federici M, Menini S. Metabolically healthy versus metabolically unhealthy obesity. Metabolism. 2019;92:51-60.
18. Tanriover C, Copur S, Gaipov A, Ozlusen B, Akcan RE, Kuwabara M, et al. Metabolically healthy obesity: Misleading phrase or healthy phenotype? European Journal of Internal Medicine. 2023.
19. De Heredia FP, Gómez-Martínez S, Marcos A. Obesity, inflammation and the immune system. Proceedings of the Nutrition Society. 2012;71(2):332-8.
20. Bornath DP, McKie GL, McCarthy SF, Vanderheyden LW, Howe GJ, Medeiros PJ, et al. Interleukin‐6 is not involved in appetite regulation following moderate‐intensity exercise in males with normal weight and obesity. Obesity. 2023.
21. Scheede-Bergdahl C, Watt HL, Trutschnigg B, Kilgour RD, Haggarty A, Lucar E, et al. Is IL-6 the best pro-inflammatory biomarker of clinical outcomes of cancer cachexia? Clinical nutrition. 2012;31(1):85-8.
22. Ashraf H, Laway BA, Wani AI. Evaluation of proinflammatory cytokines in obese vs non-obese patients with metabolic syndrome. Indian journal of endocrinology and metabolism. 2018;22(6):751.
23. Baiju N, Rylander C, Sætrom P, Sandanger TM, Nøst TH. Associations of gene expression in blood with BMI and weight changes among women in the Norwegian Women and Cancer postgenome cohort. Obesity. 2023.
24. Hearon Jr CM, Reddy S, Dias KA, Shankar A, MacNamara J, Levine B, et al. Characterizing regional and global effects of epicardial adipose tissue on cardiac systolic and diastolic function. Obesity. 2023;31(7):1884-93.
25. Rzepa Ł, Peller M, Eyileten C, Rosiak M, Kondracka A, Mirowska-Guzel D, et al. Resistin is Associated with Inflammation and Renal Function, but not with Insulin Resistance in Type 2 Diabetes. Hormone and Metabolic Research. 2021;53(07):478-84.
26. Muntner P, Einhorn PT, Cushman WC, Whelton PK, Bello NA, Drawz PE, et al. Blood pressure assessment in adults in clinical practice and clinic-based research: JACC scientific expert panel. Journal of the American College of Cardiology. 2019;73(3):317-35.
27. Ahmad S, Zaib S. An Evaluation of Biomarkers as Determinants of Peripheral Arterial Disease in those with Diabetes Mellitus. ChemistrySelect. 2023;8(13):e202300297.
28. Soomro RS, Shah IA, Saboor A, Bhutto AUB, Memon S. Sensitivity and specificity of hepatitis B virus screening via rapid immunoassay chromatographic test. Cureus. 2021;13(1).
29. de Luis D, Primo D, Izaola O, Hoyos EG, Gómez JJL. Relationship of circulating resistin levels with muscle mass determined by bioelectrical impedance in females with obesity. Endocrinología, Diabetes y Nutrición (English ed). 2023;70(7):468-75.
30. Christou KA, Christou GA, Karamoutsios A, Vartholomatos G, Gartzonika K, Tsatsoulis A, et al. The regulation of serum resistin levels in metabolically healthy and unhealthy obese individuals. Hormones. 2020;19:523-9.
31. Mabrouk R, Ghareeb H, Shehab A, Omar K, El-Kabarity RH, Soliman DA, et al. Serum visfatin, resistin and IL-18 in A group of Egyptian obese diabetic and non diabetic individuals. Egypt J Immunol. 2013;20(1):1-11.
32. Alissa EM, Alzughaibi LS, Marzouki ZM. Association between serum resistin, adiposity measures and inflammatory makers in women without cardiovascular diseases. Chemistry and physics of lipids. 2019;218:136-40.
33. Rathwa N, Patel R, Palit SP, Ramachandran A, Begum R. Genetic variants of resistin and its plasma levels: Association with obesity and dyslipidemia related to type 2 diabetes susceptibility. Genomics. 2019;111(4):980-5.
34. Zhang Y, Li Y, Yu L, Zhou L. Association between serum resistin concentration and hypertension: A systematic review and meta-analysis. Oncotarget. 2017;8(25):41529.
35. Bielecka-Dabrowa A, Bartlomiejczyk MA, Sakowicz A, Maciejewski M, Banach M. The role of adipokines in the development of arterial stiffness and hypertension. Angiology. 2020;71(8):754-61.
36. Asibey O, Yeboah FA, Owiredu W, Acheampong E, Anto EO, Owusu IK. Interplay of adipokines in the pathogenesis of essential hypertension: A comparative cross-sectional in Ghana. Alexandria journal of medicine. 2018;54(4):469-74.
37. Owecki M, Nikisch E, Miczke A, Pupek-Musialik D, Sowinski J. Serum resistin is related to plasma HDL cholesterol and inversely correlated with LDL cholesterol in diabetic and obese humans. Neuroendocrinology Letters. 2010;31(5):673.
38. Santilli F, Liani R, Di Fulvio P, Formoso G, Simeone P, Tripaldi R, et al. Increased circulating resistin is associated with insulin resistance, oxidative stress and platelet activation in type 2 diabetes mellitus. Thrombosis and haemostasis. 2016;116(12):1089-99.
39. Siddiqui K, Joy SS, George TP. Circulating resistin levels in relation with insulin resistance, inflammatory and endothelial dysfunction markers in patients with type 2 diabetes and impaired fasting glucose. Endocrine and Metabolic Science. 2020;1(3-4):100059.
40. Mostafazadeh M, Haiaty S, Rastqar A, Keshvari M. Correlation between resistin level and metabolic syndrome component: a review. Hormone and Metabolic Research. 2018;50(07):521-36.
41. Jang JC, Chen G, Wang SH, Barnes MA, Chung JI, Camberis M, et al. Macrophage-derived human resistin is induced in multiple helminth infections and promotes inflammatory monocytes and increased parasite burden. PLoS pathogens. 2015;11(1):e1004579.
42. Park HK, Kwak MK, Kim HJ, Ahima RS. Linking resistin, inflammation, and cardiometabolic diseases. The Korean journal of internal medicine. 2017;32(2):239.
43. Aquilante CL, Kosmiski LA, Knutsen SD, Zineh I. Relationship between plasma resistin concentrations, inflammatory chemokines, and components of the metabolic syndrome in adults. Metabolism. 2008;57(4):494-501.
44. Dong X, Du Q, Yu W, Zhang Z, Zhu Q, Che Z, et al. Plasma resistin, associated with single nucleotide polymorphism-420, is correlated with C-reactive protein in Chinese Han patients with spontaneous basal ganglia hemorrhage. Genet Mol Res. 2012;11(3):1841-50.
45. Xu R, Shen P, Wu C, Wan Y, Fan Z, Gao X. BMI, high-sensitivity C-reactive protein and the conversion from metabolically healthy to unhealthy phenotype in Chinese adults: a cohort study. Public Health Nutrition. 2021;24(13):4124-31.
46. Cobos-Palacios L, Ruiz-Moreno MI, Vilches-Perez A, Vargas-Candela A, Muñoz-Úbeda M, Benítez Porres J, et al. Metabolically healthy obesity: Inflammatory biomarkers and adipokines in elderly population. Plos one. 2022;17(6):e0265362.
47. Sun X, Qiu WW, Wu J, Ding SL, Wu RZ. Associations between the levels of circulating inflammatory adipokines and the risk of type 2 diabetes in Chinese male individuals: A case–control study. Journal of Clinical Laboratory Analysis. 2023;37(6):e24875.