English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Leptin is mainly produced by mature adipo‐ cytes and plays a key role in the long ‐term reg‐ ulation of body energy balance and body weight. Paradoxically, leptin levels are significantly in‐ creased in subjects with obesity, suggesting leptin resistance when produced excessively.4‐6 Meanwhile, plasma adiponectin levels are in‐ versely related to the amount of visceral fat.7 Therefore, in patients with obesity and cardio‐ metabolic diseases, leptin levels are elevated, whereas adiponectin levels are decreased. This leptin‐to‐adiponectin imbalance leads to a proin‐ flammatory state, which is associated with insu‐ lin resistance and endothelial dysfunction, pro‐ moting the loss of the vasodilatory, antithrom‐ botic, and antiatherogenic properties of the en‐ dothelial cells.4,5,8 In a previous study on an ex vivo model in which fragments of internal mammary arter‐ ies were obtained from patients undergoing coronary artery bypass graft surgery, abdom‐ inal obesity was correlated with leptin‐to‐ad‐ iponectin imbalance and was associated with a weaker vascular response to acetylcholine and an increased vasoconstrictor response to an‐ giotensin II.9 Moreover, leptin and adiponec‐ tin have been shown to be independently asso‐ ciated with T2D and CVD, but the association with the leptin‐to‐adiponectin ratio is stron‐ ger than with leptin or adiponectin levels sepa‐ rately.4,9,10 Hence, the serum leptin‐to‐adiponec‐ tin ratio may be used as an integrated marker Anisocytosis, which is determined by red blood cell distribution width (RDW), indicates the presence of erythrocytes of widely differing volumes and is mainly employed for differential diagnosis of anemias.1 However, it has been sug‐ gested that anisocytosis (ie, high RDW) is asso‐ ciated with the severity and prognosis of sever‐ al diseases, including type 2 diabetes (T2D) and cardiovascular diseases (CVDs).1,2 Furthermore, studies evaluating its diagnostic accuracy have reported good results. In a cohort of 3529 pa‐ tients, the RDW value independently predict‐ ed long ‐term all ‐cause mortality and cardiovas‐ cular comorbidities such as hypertension, T2D, peripheral artery disease, and ischemic cardiac disease.3 However, to date, it remains to be es‐ tablished by which mechanism increased RDW is associated with cardiovascular risk or wheth‐ er it is actually a surrogate marker of an under‐ lying metabolic disorder. On the other hand, the leptin‐to‐adiponec‐ tin ratio and low ‐grade systemic inflammation have a well ‐established role in the pathogenesis of T2D and CVD. Leptin and adiponectin have opposing effects on systemic low ‐grade inflam‐ mation and insulin resistance.4,5 Leptin upreg‐ ulates proinflammatory and atherogenic cyto‐ kines, such as tumor necrosis factor α and in‐ terleukin 6, while adiponectin downregulates the expression and release of several proinflam‐ matory mediators and has anti ‐inflammatory, antiatherogenic, and antidiabetic properties.4,5 Correspondence to: Patricio López ‐Jaramillo, MD, PhD, FACP, MASIRA Institute, Faculty of Health Sciences, University of Santander (UDES), Campus Universitario Lagos del Cacique, Calle 70 No 55‐210, 680003 Bucaramanga, Colombia, phone: +57 315 3068939, email: jplopezj@gmail.com Received: April 8, 2020. Accepted: April 9, 2020. Published online: May 25, 2020. Kardiol Pol. 2020; 78 (5): 381‐382 doi:10.33963/KP.15381 Copyright by the Author(s), 2020 E D I T O R I A L

kardiologia polska

Relationship among the leptin-to-adiponectin ratio, systemic inflammation, and anisocytosis: a plausible pathophysiological mechanism of a novel cardiovascular risk marker