Comparative analysis of the cytokine and adipokine profile and their associations with clinical and laboratory parameters in patients with metabolic syndrome, atrial fibrillation, and their combination

Abstract

Aim . To compare the concentrations of pro-inflammatory (interleukin (IL)-1β, IL-6, tumor necrosis factor-α) and anti-inflammatory (IL-4, IL-10) cytokines, as well as leptin and adiponectin, and to evaluate their independent associations with anthropometric, metabolic, and echocardiographic parameters in patients with isolated metabolic syndrome (MS), isolated atrial fibrillation (AF), and their combination. Material and methods . This cross-sectional observational study included 230 patients divided into following groups: control (n=50), MS without AF (n=50), MS+AF (n=80), and AF without MS (n=50). The study protocol included anthropometry, lipid profile assessment, fasting glucose measurement, echocardiography, and enzyme-linked immunosorbent assay (ELISA) for cytokines and adipokines. Statistical analysis was performed using the Kruskal-Wallis test with Bonferroni correction, Spearman’s correlation, as well as logistic, linear, and hierarchical regression models. Results . The most pronounced cardiac remodeling was observed in the MS+AF group. Levels of pro-inflammatory cytokines and IL-10 were significantly elevated in all groups compared to controls (p<0,001). In multivariate logistic regression, only adiponectin maintained an independent inverse association with AF. Other independent factors associated with AF were age (odds ratio (OR) =1,13; p<0,001), female sex (OR=3,29; 95% CI: 1,27-8,50; p=0,014), and hypertension (OR=28,1; 95% CI: 5,27-149,9; p<0,001). Leptin and pro-inflammatory cytokines lost their significance after adjustment for confounders. In hierarchical regression models, the addition of the studied biochemical markers (adiponectin, leptin, and IL-6) did not increase the explained variance of left atrial volume (ΔR 2 =0,007; p=0,509) or left ventricular ejection fraction (ΔR 2 =0,005; p=0,635). Conclusion . Adiponectin is an independent factor inversely associated with AF. Cytokines and leptin do not improve the explanation of echocardiographic parameters. Lower adiponectin concentrations are associated with AF in patients with MS and may be considered as a potential additional marker.