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. 2020 Oct 7;19(1):170.
doi: 10.1186/s12933-020-01151-z.

Association between omentin-1 and major cardiovascular events after lower extremity endovascular revascularization in diabetic patients: a prospective cohort study

Federico Biscetti  1   2   3   4 , Elisabetta Nardella  5 , Maria Margherita Rando  5 , Andrea Leonardo Cecchini  5 , Flavia Angelini  6 , Alessandro Cina  7 , Roberto Iezzi  7 , Marco Filipponi  8 , Angelo Santoliquido  9   10   11 , Dario Pitocco  9   10   12 , Raffaele Landolfi  9   5   10 , Andrea Flex  9   5   6   10
Affiliations

Association between omentin-1 and major cardiovascular events after lower extremity endovascular revascularization in diabetic patients: a prospective cohort study

Federico Biscetti et al. Cardiovasc Diabetol. .

Abstract

Background: Cardiovascular complications represent the major cause of morbidity and mortality of type 2 diabetes mellitus (T2DM) patients. In particular, peripheral artery disease (PAD) represents a frequent T2DM vascular complication and a risk factor for the development of major adverse cardiovascular events (MACE). Among adipokines, omentin-1 serum levels are reduced in T2DM patients with PAD and are inversely related to disease severity.

Objective: To study the relationship between omentin-1 levels, at baseline, with outcomes after endovascular procedures in T2DM patients with PAD and chronic limb-threatening ischemia (CLTI).

Research design and methods: We enrolled for our prospective non-randomized study, 207 T2DM patients with PAD and CLTI, requiring revascularization. Omentin-1 serum levels were collected before revascularization and patients incidence outcomes were evaluated at 1, 3, 6 and 12 months.

Results: Omentin-1 was reduced in patients with more severe disease (27.24 ± 4.83 vs 30.82 ± 5.48 ng/mL, p < 0.001). Overall, 84 MACE and 96 major adverse limb events (MALE) occurred during the 12-month follow-up. We observed that omentin-1 levels were lower in patients with MACE (26.02 ± 4.05 vs 31.33 ± 5.29 ng/mL, p < 0.001) and MALE (26.67 ± 4.21 vs 31.34 ± 5.54 ng/mL, p < 0.001). The association between omentin-1, MACE and MALE remained significant after adjusting for major risk factors in a multivariate analysis. Receiver operating characteristics (ROC) curve using omentin-1 levels predicted incidence events (area under the curve = 0.80).

Conclusions: We demonstrated that reduced omentin-1 levels, at baseline, are related with worse vascular outcomes in T2DM patients with PAD and CLTI undergoing an endovascular procedure.

Keywords: Chronic limb-threatening ischemia; Major adverse limb events; Omentin-1; Outcome prediction; Type 2 diabetes mellitus.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a Omentin-1 levels according to PAD severity. On the box plots, central lines represent the median, the length of the box represents the interquartile range and the lines extend to minimum and maximum values. ***P < 0.001. b Dispersion graph showing the correlation between Ankle Brachial Index (ABI) and omentin-1 serum levels.
Fig. 2
Fig. 2
a Omentin-1 levels according to MACE. On the box plots, central lines represent the median, the length of the box represents the interquartile range and the lines extend to minimum and maximum values. ***P < 0.001. b Omentin-1 levels according to MALE. On the box plots, central lines represent the median, the length of the box represents the interquartile range and the lines extend to minimum and maximum values. ***P < 0.001.
Fig. 3
Fig. 3
a Omentin-1 levels according to mortality. On the box plots, central lines represent the median, the length of the box represents the interquartile range and the lines extend to minimum and maximum values. ***P < 0.001. b Omentin-1 levels according to coronary artery disease (CAD) outcome. On the box plots, central lines represent the median, the length of the box represents the interquartile range and the lines extend to minimum and maximum values. ***P < 0.001. c Omentin-1 levels according to cerebrovascular disease (CVD) outcome. On the box plots, central lines represent the median, the length of the box represents the interquartile range and the lines extend to minimum and maximum values. ***P < 0.001.
Fig. 4
Fig. 4
ROC curve analysis to predict absence of MACE related to omentin-1 levels in T2DM showing an area under the ROC curve of 0.804 (P < 0.001)
Fig. 5
Fig. 5
The freedom from MACE according to the quartiles of serum omentin-1 was estimated using the Kaplan–Meier method and compared using the Log-Rank test (P < 0.001). The quartiles of omentin-1 are listed in color code lines. Blue represents the first quartile, red the second, green the third, orange the fourth
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