BACKGROUND AND AIMS: Some crucial associations between obesity-related altered adipokine
levels and the main factors of atherosclerotic, atherothrombotic processes are not
fully known. We analysed the relationships of classic adipokines, namely leptin, resistin,
adiponectin, tumour necrosis factor-alpha (TNF-alpha), interleukin 6 (IL-6) with the
markers of platelet activation, including mean platelet volume (MPV), platelet surface/soluble
P-selectin, platelet-derived microparticles (PMPs), the parameters of coagulation
abnormalities and common carotid intima-media thickness (IMT) in obese patients with
or without atherosclerotic comorbidities in comparison to age- and sex-matched controls.
METHODS AND RESULTS: We enrolled 154 obese individuals, including 98 suffering from
atherosclerotic concomitant conditions, 56 free of atherosclerotic comorbidities and
62 healthy controls. Plasma levels of leptin, resistin, adiponectin, TNF-alpha, IL-6,
soluble P-selectin, and plasminogen activator inhibitor-1 antigen (PAI-1 ag) were
analysed by ELISA. Platelet surface P-selectin and PMPs were measured by flow cytometry.
IMT was detected by ultrasonography. Adipokines were closely associated with markers
of platelet hyperactivity, hypercoagulability, hypofibrinolysis and IMT. Significant
independent associations were found between leptin and platelet count (p < 0.0001),
MPV (p = 0.019), PMPs (p < 0.0001), fibrinogen (p = 0.001), factor VIII (FVIII) activity
(p = 0.035); adiponectin and PAI-1 ag (p = 0.035); resistin and soluble P-selectin
(p = 0.002); TNF-alpha and PAI-1 ag (p < 0.0001); and IL-6 and fibrinogen (p = 0.011).
Finally, leptin (p = 0.0005), adiponectin (p = 0.019), IL-6 (p = 0.001), MPV (p =
0.0003), PMP (p = 0.008), and FVIII activity (p = 0.043) were independent predictors
of IMT. CONCLUSION: Overall, we suggest that in obese subjects altered adipokine levels
play a key role in common carotid atherosclerosis both directly and through haemostatic
parameters.
