Increased Levels of ANGPTL3 and CTRP9 in Patients With Obstructive Sleep Apnea and Their Relation to Insulin Resistance and Lipid Metabolism and Markers of Endothelial Dysfunction

Association between circulating CTRP9 levels and coronary artery disease: a systematic review and meta-analysis

Background

C1q tumor necrosis factor (TNF) related proteins 9 (CTRP9) is a novel adipocytokine that has been shown to have a cardioprotective effect in coronary artery disease (CAD). However, there are conflicting results on circulating levels of CTRP9 in patients with and without CAD. This meta-analysis was conducted to investigate the association between circulating CTRP9 levels and CAD.

Objective

The aim of this meta-analysis was to re-examine the relationship between circulating CTRP9 levels and CAD.

Methods

We searched PubMed, Web of Science, Embase, Cochrane Library, CNKI, VIP, Wanfang Data, and CBM for relevant studies up to October 2023, and 193 articles were identified. After reading the title, abstract and full text, a total of 25 articles were included in this meta-analysis. A prespecified protocol registered at INPLASY was followed (INPLASY202450066). Due to the high heterogeneity, we performed subgroup analyses and meta-regression based on patient characteristics, complications, clinical biochemical indicators, coronary artery lesion, and CAD classification. Publication bias was assessed using Egger's linear regression tests, Begg's rank correlation tests, and funnel plots.

Results

The results showed that the patient with CAD had significantly lower circulating CTRP9 levels than the control group (Z = 3.26, P = 0.001). Subgroup analysis and meta-regression findings demonstrated that observed heterogeneity could be attributed to population distribution. Patient characteristics (year of publication, patients' age, and BMI), complications (diabetes and type 2 diabetes mellitus (T2DM)), clinical biochemical indicators, coronary artery lesion (stability of coronary atherosclerotic plaque, and the number of diseased coronary vessels), and classification of CAD were not identified as source of heterogeneity.

Conclusions

The meta-analysis confirmed that circulating CTRP9 levels in CAD patients are significantly lower than those in patients without CAD. The association may be modified by the population distribution.

High-density lipoprotein cholesterol efflux capacity in patients with obstructive sleep apnea and its relation with disease severity

Background

Obstructive sleep apnea (OSA) is linked to an accelerated risk of cardiovascular disease (CVD). Some key CVD risk factors are present in patients suffering from OSA such as hypertension, inflammation, oxidative stress, and dyslipidemia. High-density lipoprotein (HDL) cholesterol efflux capacity (CEC) is proposed as a reliable biomarker of HDL function and the present study aimed to quantify this biomarker in patients with OSA.

Methods

ATP binding cassette subfamily A member 1 (ABCA1), non-ABCA1, and total CEC were determined in 69 polysomnographic-confirmed OSA patients and 23 controls. Moreover, paraoxonase (PON) activities, high-sensitivity C-reactive protein (hsCRP), apolipoprotein B (apo B), and apolipoprotein A-I (apo A-I) circulating levels were quantified in the studied population.

Results: All CEC measures were reduced in the OSA group compared to the control group. Strikingly, ABCA1 CEC was diminished in severe OSA in comparison with mild OSA. Furthermore, PON activities and apo A-I showed lower levels, while hsCRP and apo B were elevated in OSA patients compared to controls. Moreover, ABCA1 CEC showed an inverse association with hsCRP and a positive association with apo A-I, while non-ABCA1 CEC presented an association with HDL-C.

Conclusion

These results suggest the presence of an impaired HDL function in OSA. In particular, ABCA1 CEC was associated with disease severity and inflammation which could be a factor increasing the risk of CVD.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12944-022-01723-w.