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Published in: Inflammation Research 5/2010

01-05-2010 | Review

Association between serum amyloid A and obesity: a meta-analysis and systematic review

Authors: Yulan Zhao, Xuelian He, Xuegui Shi, Chengjin Huang, Jie Liu, Shuli Zhou, Chew-Kiat Heng

Published in: Inflammation Research | Issue 5/2010

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Abstract

Background

Emerging evidence indicates an association of the acute-phase protein serum amyloid A (SAA) with obesity. Here we review and summarize quantitatively the available data related to this association.

Methods

PubMed was systematically searched using the terms “serum amyloid A” and “obesity.” Eighty-one relevant studies between January 1966 and July 2009 were identified. Of these, only 11 cross-sectional studies and 10 prospective studies with successful interventions met our inclusion criteria for the meta-analysis. All analyses were conducted using the Comprehensive Meta-Analysis software. Literature pertaining to the relationship between SAA and other inflammatory markers, and the association between SAA and obesity-related disorders, such as cardiovascular diseases, atherosclerosis, diabetes, and insulin resistance was also reviewed.

Results

A strong association between body mass index and SAA levels was found in the 11 cross-sectional studies. The overall correlation coefficient is 0.230 (95% CI 0.160–0.297, P < 0.0005). The ten prospective studies were subsequently analyzed, and the difference in SAA levels before and after weight loss, expressed as standardized mean difference was −0.480 (95% CI −0.678 to −0.283, P < 0.0005). We discuss some potential underlying mechanisms and clinical applications for reducing SAA levels in obesity.
Literature
2.
go back to reference Wellen KE, Hotamisligil GS. Inflammation, stress, and diabetes. J Clin Invest. 2005;115:1111–9.PubMed Wellen KE, Hotamisligil GS. Inflammation, stress, and diabetes. J Clin Invest. 2005;115:1111–9.PubMed
3.
go back to reference Hotamisligil GS, Shargill NS, Spiegelman BM. Adipose expression of tumor-necrosis-factor-alpha—direct role in obesity-linked insulin resistance. Science. 1993;259:87–91.CrossRefPubMed Hotamisligil GS, Shargill NS, Spiegelman BM. Adipose expression of tumor-necrosis-factor-alpha—direct role in obesity-linked insulin resistance. Science. 1993;259:87–91.CrossRefPubMed
4.
go back to reference Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB. Elevated C-reactive protein levels in overweight and obese adults. JAMA. 1999;282:2131–5.CrossRefPubMed Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB. Elevated C-reactive protein levels in overweight and obese adults. JAMA. 1999;282:2131–5.CrossRefPubMed
5.
go back to reference Wallenius V, Wallenius K, Ahren B, Rudling M, Carlsten H, Dickson SL, et al. Interleukin-6-deficient mice develop mature-onset obesity. Nat Med. 2002;8:75–9.CrossRefPubMed Wallenius V, Wallenius K, Ahren B, Rudling M, Carlsten H, Dickson SL, et al. Interleukin-6-deficient mice develop mature-onset obesity. Nat Med. 2002;8:75–9.CrossRefPubMed
6.
go back to reference Weisberg SP, McCann D, Desai M, Rosenbaum M, Leibel RL, Ferrante AW. Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest. 2003;112:1796–808.PubMed Weisberg SP, McCann D, Desai M, Rosenbaum M, Leibel RL, Ferrante AW. Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest. 2003;112:1796–808.PubMed
7.
go back to reference Xu HY, Barnes GT, Yang Q, Tan Q, Yang DS, Chou CJ, et al. Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest. 2003;112:1821–30.PubMed Xu HY, Barnes GT, Yang Q, Tan Q, Yang DS, Chou CJ, et al. Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest. 2003;112:1821–30.PubMed
8.
go back to reference Malle E, de Beer FC. Human serum amyloid A (SAA) protein: a prominent acute-phase reactant for clinical practice. Eur J Clin Invest. 1996;26:427–35.CrossRefPubMed Malle E, de Beer FC. Human serum amyloid A (SAA) protein: a prominent acute-phase reactant for clinical practice. Eur J Clin Invest. 1996;26:427–35.CrossRefPubMed
9.
go back to reference Gabay C, Kushner I. Mechanisms of disease: acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999;340:448–54.CrossRefPubMed Gabay C, Kushner I. Mechanisms of disease: acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999;340:448–54.CrossRefPubMed
10.
go back to reference Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology—a proposal for reporting. JAMA. 2000;283:2008–12.CrossRefPubMed Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology—a proposal for reporting. JAMA. 2000;283:2008–12.CrossRefPubMed
11.
go back to reference Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol. 2005;5:13.CrossRefPubMed Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol. 2005;5:13.CrossRefPubMed
12.
go back to reference Kraja AT, Province MA, Arnett D, Wagenknecht L, Tang W, Hopkins PN, et al. Do inflammation and procoagulation biomarkers contribute to the metabolic syndrome cluster? Nutr Metab (Lond). 2007;4:28.CrossRef Kraja AT, Province MA, Arnett D, Wagenknecht L, Tang W, Hopkins PN, et al. Do inflammation and procoagulation biomarkers contribute to the metabolic syndrome cluster? Nutr Metab (Lond). 2007;4:28.CrossRef
13.
go back to reference Liu J, Young TK, Zinman B, Harris SB, Connelly PW, Hanley AJG. Lifestyle variables, non-traditional cardiovascular risk factors, and the metabolic syndrome in an aboriginal Canadian population. Obesity (Silver Spring). 2006;14:500–8.CrossRef Liu J, Young TK, Zinman B, Harris SB, Connelly PW, Hanley AJG. Lifestyle variables, non-traditional cardiovascular risk factors, and the metabolic syndrome in an aboriginal Canadian population. Obesity (Silver Spring). 2006;14:500–8.CrossRef
14.
go back to reference Panagiotakos DB, Pitsavos C, Yannakoulia M, Chrysohoou C, Stefanadis C. The implication of obesity and central fat on markers of chronic inflammation: the ATTICA study. Atherosclerosis. 2005;183:308–15.CrossRefPubMed Panagiotakos DB, Pitsavos C, Yannakoulia M, Chrysohoou C, Stefanadis C. The implication of obesity and central fat on markers of chronic inflammation: the ATTICA study. Atherosclerosis. 2005;183:308–15.CrossRefPubMed
15.
go back to reference Thorand B, Baumert J, Doring A, Herder C, Kolb H, Rathmann W, et al. Sex differences in the relation of body composition to markers of inflammation. Atherosclerosis. 2006;184:216–24.CrossRefPubMed Thorand B, Baumert J, Doring A, Herder C, Kolb H, Rathmann W, et al. Sex differences in the relation of body composition to markers of inflammation. Atherosclerosis. 2006;184:216–24.CrossRefPubMed
16.
go back to reference Tannock LR, O’Brien KD, Knopp RH, Retzlaff B, Fish B, Wener MH, et al. Cholesterol feeding increases C-reactive protein and serum amyloid A levels in lean insulin-sensitive subjects. Circulation. 2005;111:3058–62.CrossRefPubMed Tannock LR, O’Brien KD, Knopp RH, Retzlaff B, Fish B, Wener MH, et al. Cholesterol feeding increases C-reactive protein and serum amyloid A levels in lean insulin-sensitive subjects. Circulation. 2005;111:3058–62.CrossRefPubMed
17.
go back to reference Poitou C, Viguerie N, Cancello R, De Matteis R, Cinti S, Stich V, et al. Serum amyloid A: production by human white adipocyte and regulation by obesity and nutrition. Diabetologia. 2005;48:519–28.CrossRefPubMed Poitou C, Viguerie N, Cancello R, De Matteis R, Cinti S, Stich V, et al. Serum amyloid A: production by human white adipocyte and regulation by obesity and nutrition. Diabetologia. 2005;48:519–28.CrossRefPubMed
18.
go back to reference Verdaet D, Dendale P, De Bacquer D, Delanghe J, Block P, De Backer G. Association between leisure time physical activity and markers of chronic inflammation related to coronary heart disease. Atherosclerosis. 2004;176:303–10.CrossRefPubMed Verdaet D, Dendale P, De Bacquer D, Delanghe J, Block P, De Backer G. Association between leisure time physical activity and markers of chronic inflammation related to coronary heart disease. Atherosclerosis. 2004;176:303–10.CrossRefPubMed
19.
go back to reference Connelly PW, Hanley AJ, Harris SB, Hegele RA, Zinman B. Relation of waist circumference and glycemic status to C-reactive protein in the Sandy Lake Oji-Cree. Int J Obes Relat Metab Disord. 2003;27:347–54.CrossRefPubMed Connelly PW, Hanley AJ, Harris SB, Hegele RA, Zinman B. Relation of waist circumference and glycemic status to C-reactive protein in the Sandy Lake Oji-Cree. Int J Obes Relat Metab Disord. 2003;27:347–54.CrossRefPubMed
20.
go back to reference van Dielen FM, van’t Veer C, Schols AM, Soeters PB, Buurman WA, Greve JW. Increased leptin concentrations correlate with increased concentrations of inflammatory markers in morbidly obese individuals. Int J Obes Relat Metab Disord. 2001;25:1759–66.CrossRefPubMed van Dielen FM, van’t Veer C, Schols AM, Soeters PB, Buurman WA, Greve JW. Increased leptin concentrations correlate with increased concentrations of inflammatory markers in morbidly obese individuals. Int J Obes Relat Metab Disord. 2001;25:1759–66.CrossRefPubMed
21.
go back to reference Gomez-Ambrosi J, Azcona C, Patino-Garcia A, Fruhbeck G. Serum amyloid A concentration is increased in obese children and adolescents. J Pediatr. 2008;153:71–5.CrossRefPubMed Gomez-Ambrosi J, Azcona C, Patino-Garcia A, Fruhbeck G. Serum amyloid A concentration is increased in obese children and adolescents. J Pediatr. 2008;153:71–5.CrossRefPubMed
22.
go back to reference Leinonen E, Hurt-Camejo E, Wiklund O, Hulten LM, Hiukka A, Taskinen M-R. Insulin resistance and adiposity correlate with acute-phase reaction and soluble cell adhesion molecules in type 2 diabetes. Atherosclerosis. 2003;166:387–94.CrossRefPubMed Leinonen E, Hurt-Camejo E, Wiklund O, Hulten LM, Hiukka A, Taskinen M-R. Insulin resistance and adiposity correlate with acute-phase reaction and soluble cell adhesion molecules in type 2 diabetes. Atherosclerosis. 2003;166:387–94.CrossRefPubMed
23.
go back to reference Catalan V, Gomez-Ambrosi J, Ramirez B, Rotellar F, Pastor C, Silva C, et al. Proinflammatory cytokines in obesity: impact of type 2 diabetes mellitus and gastric bypass. Obes Surg. 2007;17:1464–74.CrossRefPubMed Catalan V, Gomez-Ambrosi J, Ramirez B, Rotellar F, Pastor C, Silva C, et al. Proinflammatory cytokines in obesity: impact of type 2 diabetes mellitus and gastric bypass. Obes Surg. 2007;17:1464–74.CrossRefPubMed
24.
go back to reference Poitou C, Coupaye M, Laaban J-P, Coussieu C, Bedel JF, Bouillot J-L, et al. Serum amyloid A and obstructive sleep apnea syndrome before and after surgically-induced weight loss in morbidly obese subjects. Obes Surg. 2006;16:1475–81.CrossRefPubMed Poitou C, Coupaye M, Laaban J-P, Coussieu C, Bedel JF, Bouillot J-L, et al. Serum amyloid A and obstructive sleep apnea syndrome before and after surgically-induced weight loss in morbidly obese subjects. Obes Surg. 2006;16:1475–81.CrossRefPubMed
25.
go back to reference Poitou C, Coussieu C, Rouault C, Coupaye M, Cancello R, Bedel J-F, et al. Serum amyloid A: a marker of adiposity-induced low-grade inflammation but not of metabolic status. Obesity (Silver Spring). 2006;14:309–18.CrossRef Poitou C, Coussieu C, Rouault C, Coupaye M, Cancello R, Bedel J-F, et al. Serum amyloid A: a marker of adiposity-induced low-grade inflammation but not of metabolic status. Obesity (Silver Spring). 2006;14:309–18.CrossRef
26.
go back to reference Gomez-Ambrosi J, Salvador J, Rotellar F, Silva C, Catalan V, Rodriguez A, et al. Increased serum amyloid A concentrations in morbid obesity decrease after gastric bypass. Obes Surg. 2006;16:262–9.CrossRefPubMed Gomez-Ambrosi J, Salvador J, Rotellar F, Silva C, Catalan V, Rodriguez A, et al. Increased serum amyloid A concentrations in morbid obesity decrease after gastric bypass. Obes Surg. 2006;16:262–9.CrossRefPubMed
27.
go back to reference Holdstock C, Lind L, Engstrom BE, Ohrvall M, Sundbom M, Larsson A, et al. CRP reduction following gastric bypass surgery is most pronounced in insulin-sensitive subjects. Int J Obes (Lond). 2005;29:1275–80.CrossRef Holdstock C, Lind L, Engstrom BE, Ohrvall M, Sundbom M, Larsson A, et al. CRP reduction following gastric bypass surgery is most pronounced in insulin-sensitive subjects. Int J Obes (Lond). 2005;29:1275–80.CrossRef
28.
go back to reference Campbell PT, Campbell KL, Wener MH, Wood BL, Potter JD, McTiernan A, et al. A yearlong exercise intervention decreases CRP among obese postmenopausal women. Med Sci Sports Exerc. 2009;41:1533–9.CrossRefPubMed Campbell PT, Campbell KL, Wener MH, Wood BL, Potter JD, McTiernan A, et al. A yearlong exercise intervention decreases CRP among obese postmenopausal women. Med Sci Sports Exerc. 2009;41:1533–9.CrossRefPubMed
29.
go back to reference Lappalainen T, Kolehmainen M, Schwab U, Pulkkinen L, Laaksonen DE, Rauramaa R, et al. Serum concentrations and expressions of serum amyloid A and leptin in adipose tissue are interrelated: the Genobin Study. Eur J Endocrinol. 2008;158:333–41.CrossRefPubMed Lappalainen T, Kolehmainen M, Schwab U, Pulkkinen L, Laaksonen DE, Rauramaa R, et al. Serum concentrations and expressions of serum amyloid A and leptin in adipose tissue are interrelated: the Genobin Study. Eur J Endocrinol. 2008;158:333–41.CrossRefPubMed
30.
go back to reference Salas-Salvado J, Bullo M, Garcia-Lorda P, Figueredo R, Del Castillo D, Bonada A, et al. Subcutaneous adipose tissue cytokine production is not responsible for the restoration of systemic inflammation markers during weight loss. Int J Obes (Lond). 2006;30:1714–20.CrossRef Salas-Salvado J, Bullo M, Garcia-Lorda P, Figueredo R, Del Castillo D, Bonada A, et al. Subcutaneous adipose tissue cytokine production is not responsible for the restoration of systemic inflammation markers during weight loss. Int J Obes (Lond). 2006;30:1714–20.CrossRef
31.
go back to reference O’Brien KD, Brehm BJ, Seeley RJ, Bean J, Wener MH, Daniels S, et al. Diet-induced weight loss is associated with decreases in plasma serum amyloid A and C-reactive protein independent of dietary macronutrient composition in obese subjects. J Clin Endocrinol Metab. 2005;90:2244–9.CrossRefPubMed O’Brien KD, Brehm BJ, Seeley RJ, Bean J, Wener MH, Daniels S, et al. Diet-induced weight loss is associated with decreases in plasma serum amyloid A and C-reactive protein independent of dietary macronutrient composition in obese subjects. J Clin Endocrinol Metab. 2005;90:2244–9.CrossRefPubMed
32.
go back to reference Danesh J, Muir J, Wong YK, Ward M, Gallimore JR, Pepys MB. Risk factors for coronary heart disease and acute-phase proteins. A population-based study. Eur Heart J. 1999;20:954–9.CrossRefPubMed Danesh J, Muir J, Wong YK, Ward M, Gallimore JR, Pepys MB. Risk factors for coronary heart disease and acute-phase proteins. A population-based study. Eur Heart J. 1999;20:954–9.CrossRefPubMed
33.
go back to reference Carter KW, Hung J, Powell BL, Wiltshire S, Foo BTX, Leow YC, et al. Association of interleukin-1 gene polymorphisms with central obesity and metabolic syndrome in a coronary heart disease population. Hum Genet. 2008;124:199–206.CrossRefPubMed Carter KW, Hung J, Powell BL, Wiltshire S, Foo BTX, Leow YC, et al. Association of interleukin-1 gene polymorphisms with central obesity and metabolic syndrome in a coronary heart disease population. Hum Genet. 2008;124:199–206.CrossRefPubMed
34.
go back to reference Roytblat L, Rachinsky M, Fisher A, Greemberg L, Shapira Y, Doudevani A, et al. Raised interleukin-6 levels in obese patients. Obes Res. 2000;8:673–5.CrossRefPubMed Roytblat L, Rachinsky M, Fisher A, Greemberg L, Shapira Y, Doudevani A, et al. Raised interleukin-6 levels in obese patients. Obes Res. 2000;8:673–5.CrossRefPubMed
35.
go back to reference Jiao P, Chen Q, Shah S, Du J, Tao B, Tzameli I, et al. Obesity-related upregulation of monocyte chemotactic factors in adipocytes involvement of nuclear factor-kappa B and c-Jun NH2-terminal kinase pathways. Diabetes. 2009;58:104–15.CrossRefPubMed Jiao P, Chen Q, Shah S, Du J, Tao B, Tzameli I, et al. Obesity-related upregulation of monocyte chemotactic factors in adipocytes involvement of nuclear factor-kappa B and c-Jun NH2-terminal kinase pathways. Diabetes. 2009;58:104–15.CrossRefPubMed
36.
go back to reference Chacon MR, Fernandez-Real JM, Richart C, Megia A, Gomez JM, Miranda M, et al. Monocyte chemoattractant protein-1 in obesity and type 2 diabetes. Insulin sensitivity study. Obesity. 2007;15:664–72.CrossRefPubMed Chacon MR, Fernandez-Real JM, Richart C, Megia A, Gomez JM, Miranda M, et al. Monocyte chemoattractant protein-1 in obesity and type 2 diabetes. Insulin sensitivity study. Obesity. 2007;15:664–72.CrossRefPubMed
37.
go back to reference Kanda H, Tateya S, Tamori Y, Kotani K, Hiasa KI, Kitazawa R, et al. MCP-1 contributes to macrophage infiltration into adipose tissue, insulin resistance, and hepatic steatosis in obesity. J Clin Invest. 2006;116:1494–505.CrossRefPubMed Kanda H, Tateya S, Tamori Y, Kotani K, Hiasa KI, Kitazawa R, et al. MCP-1 contributes to macrophage infiltration into adipose tissue, insulin resistance, and hepatic steatosis in obesity. J Clin Invest. 2006;116:1494–505.CrossRefPubMed
38.
go back to reference Sola E, Vaya A, Espana F, Castello R, Ramon LA, Hernandez-Mijares A, et al. Plasminogen activator inhibitor-1 levels in severe and morbid obesity. Effect of weight loss and influence of 4G/5G polymorphism. Thromb Res. 2008;122:320–7.CrossRefPubMed Sola E, Vaya A, Espana F, Castello R, Ramon LA, Hernandez-Mijares A, et al. Plasminogen activator inhibitor-1 levels in severe and morbid obesity. Effect of weight loss and influence of 4G/5G polymorphism. Thromb Res. 2008;122:320–7.CrossRefPubMed
39.
go back to reference Pou KM, Massaro JM, Hoffmann U, Vasan RS, Maurovich-Horvat P, Larson MG, et al. Visceral and subcutaneous adipose tissue volumes are cross-sectionally related to markers of inflammation and oxidative stress—the Framingham Heart Study. Circulation. 2007;116:1234–41.CrossRefPubMed Pou KM, Massaro JM, Hoffmann U, Vasan RS, Maurovich-Horvat P, Larson MG, et al. Visceral and subcutaneous adipose tissue volumes are cross-sectionally related to markers of inflammation and oxidative stress—the Framingham Heart Study. Circulation. 2007;116:1234–41.CrossRefPubMed
40.
go back to reference Greenfield JR, Samaras K, Jenkins AB, Kelly PJ, Spector TD, Gallimore JR, et al. Obesity is an important determinant of baseline serum C-reactive protein concentration in monozygotic twins, independent of genetic influences. Circulation. 2004;109:3022–8.CrossRefPubMed Greenfield JR, Samaras K, Jenkins AB, Kelly PJ, Spector TD, Gallimore JR, et al. Obesity is an important determinant of baseline serum C-reactive protein concentration in monozygotic twins, independent of genetic influences. Circulation. 2004;109:3022–8.CrossRefPubMed
41.
go back to reference Madsen EL, Rissanen A, Bruun JM, Skogstrand K, Tonstad S, Hougaard DM, et al. Weight loss larger than 10% is needed for general improvement of levels of circulating adiponectin and markers of inflammation in obese subjects: a 3-year weight loss study. Eur J Endocrinol. 2008;158:179–87.CrossRefPubMed Madsen EL, Rissanen A, Bruun JM, Skogstrand K, Tonstad S, Hougaard DM, et al. Weight loss larger than 10% is needed for general improvement of levels of circulating adiponectin and markers of inflammation in obese subjects: a 3-year weight loss study. Eur J Endocrinol. 2008;158:179–87.CrossRefPubMed
42.
go back to reference Esposito K, Pontillo A, Di Palo C, Giugliano G, Masella M, Marfella R, et al. Effect of weight loss and lifestyle changes on vascular inflammatory markers in obese women—a randomized trial. JAMA. 2003;289:1799–804.CrossRefPubMed Esposito K, Pontillo A, Di Palo C, Giugliano G, Masella M, Marfella R, et al. Effect of weight loss and lifestyle changes on vascular inflammatory markers in obese women—a randomized trial. JAMA. 2003;289:1799–804.CrossRefPubMed
43.
go back to reference Cancello R, Henegar C, Viguerie N, Taleb S, Poitou C, Rouault C, et al. Reduction of macrophage infiltration and chemoattractant gene expression changes in white adipose tissue of morbidly obese subjects after surgery induced weight loss. Diabetes. 2005;54:2277–86.CrossRefPubMed Cancello R, Henegar C, Viguerie N, Taleb S, Poitou C, Rouault C, et al. Reduction of macrophage infiltration and chemoattractant gene expression changes in white adipose tissue of morbidly obese subjects after surgery induced weight loss. Diabetes. 2005;54:2277–86.CrossRefPubMed
44.
go back to reference Lee CG, Carr MC, Murdoch SJ, Mitchell E, Woods NF, Wener MH, et al. Adipokines, inflammation, and visceral adiposity across the menopausal transition: a prospective study. J Clin Endocrinol Metab. 2009;94:1104–10.CrossRefPubMed Lee CG, Carr MC, Murdoch SJ, Mitchell E, Woods NF, Wener MH, et al. Adipokines, inflammation, and visceral adiposity across the menopausal transition: a prospective study. J Clin Endocrinol Metab. 2009;94:1104–10.CrossRefPubMed
45.
go back to reference Libby P, Ridker PM. Novel inflammatory markers of coronary risk—theory versus practice. Circulation. 1999;100:1148–50.PubMed Libby P, Ridker PM. Novel inflammatory markers of coronary risk—theory versus practice. Circulation. 1999;100:1148–50.PubMed
46.
go back to reference Ridker PM, Brown NJ, Vaughan DE, Harrison DG, Mehta JL. Established and emerging plasma biomarkers in the prediction of first atherothrombotic events. Circulation. 2004;109:IV6–19.PubMed Ridker PM, Brown NJ, Vaughan DE, Harrison DG, Mehta JL. Established and emerging plasma biomarkers in the prediction of first atherothrombotic events. Circulation. 2004;109:IV6–19.PubMed
47.
go back to reference Koh KK, Han SH, Quon MJ. Inflammatory markers and the metabolic syndrome—insights from therapeutic interventions. J Am Coll Cardiol. 2005;46:1978–85.CrossRefPubMed Koh KK, Han SH, Quon MJ. Inflammatory markers and the metabolic syndrome—insights from therapeutic interventions. J Am Coll Cardiol. 2005;46:1978–85.CrossRefPubMed
48.
go back to reference Yang R-Z, Lee M-J, Hu H, Pollin TI, Ryan AS, Nicklas BJ, et al. Acute-phase serum amyloid A: an inflammatory adipokine, potential link between obesity, its metabolic complications. PLoS Med. 2006;3:e287.CrossRefPubMed Yang R-Z, Lee M-J, Hu H, Pollin TI, Ryan AS, Nicklas BJ, et al. Acute-phase serum amyloid A: an inflammatory adipokine, potential link between obesity, its metabolic complications. PLoS Med. 2006;3:e287.CrossRefPubMed
49.
go back to reference Liuzzo G, Biasucci LM, Gallimore JR, Grillo RL, Rebuzzi AG, Pepys MB, et al. The prognostic value of C-reactive protein and serum amyloid-A protein in severe unstable angina. N Engl J Med. 1994;331:417–24.CrossRefPubMed Liuzzo G, Biasucci LM, Gallimore JR, Grillo RL, Rebuzzi AG, Pepys MB, et al. The prognostic value of C-reactive protein and serum amyloid-A protein in severe unstable angina. N Engl J Med. 1994;331:417–24.CrossRefPubMed
50.
go back to reference Meek RL, Urielishoval S, Benditt EP. Expression of apolipoprotein serum amyloid-A messenger-RNA in human atherosclerotic lesions and cultured vascular cells—implications for serum amyloid-A function. Proc Natl Acad Sci USA. 1994;91:3186–90.CrossRefPubMed Meek RL, Urielishoval S, Benditt EP. Expression of apolipoprotein serum amyloid-A messenger-RNA in human atherosclerotic lesions and cultured vascular cells—implications for serum amyloid-A function. Proc Natl Acad Sci USA. 1994;91:3186–90.CrossRefPubMed
51.
go back to reference Kinlay S, Schwartz GG, Olsson AG, Rifai N, Szarek M, Waters DD, et al. Inflammation, statin therapy, and risk of stroke after an acute coronary syndrome in the MIRACL study. Arterioscler Thromb Vasc Biol. 2008;28:142–7.CrossRefPubMed Kinlay S, Schwartz GG, Olsson AG, Rifai N, Szarek M, Waters DD, et al. Inflammation, statin therapy, and risk of stroke after an acute coronary syndrome in the MIRACL study. Arterioscler Thromb Vasc Biol. 2008;28:142–7.CrossRefPubMed
52.
go back to reference Helmersson J, Vessby B, Larsson A, Basu S. Association of type 2 diabetes with cyclooxygenase-mediated inflammation and oxidative stress in an elderly population. Circulation. 2004;109:1729–34.CrossRefPubMed Helmersson J, Vessby B, Larsson A, Basu S. Association of type 2 diabetes with cyclooxygenase-mediated inflammation and oxidative stress in an elderly population. Circulation. 2004;109:1729–34.CrossRefPubMed
53.
go back to reference Scheja L, Heese B, Zitzer H, Michael MD, Siesky AM, Pospisil H, et al. Acute-phase serum amyloid A as a marker of insulin resistance in mice. Exp Diabetes Res. 2008;2008:230837.PubMed Scheja L, Heese B, Zitzer H, Michael MD, Siesky AM, Pospisil H, et al. Acute-phase serum amyloid A as a marker of insulin resistance in mice. Exp Diabetes Res. 2008;2008:230837.PubMed
54.
go back to reference Jacobs M, van Greevenbroek MMJ, van der Kallen CJH, Ferreira I, Blaak EE, Feskens EJM, et al. Low-grade inflammation can partly explain the association between the metabolic syndrome and either coronary artery disease or severity of peripheral arterial disease: the CODAM study. Eur J Clin Invest. 2009;39:437–44.CrossRefPubMed Jacobs M, van Greevenbroek MMJ, van der Kallen CJH, Ferreira I, Blaak EE, Feskens EJM, et al. Low-grade inflammation can partly explain the association between the metabolic syndrome and either coronary artery disease or severity of peripheral arterial disease: the CODAM study. Eur J Clin Invest. 2009;39:437–44.CrossRefPubMed
55.
go back to reference Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med. 2000;342:836–43.CrossRefPubMed Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med. 2000;342:836–43.CrossRefPubMed
56.
go back to reference Johnson BD, Kip KE, Marroquin OC, Ridker PM, Kelsey SF, Shaw LJ, et al. Serum amyloid A as a predictor of coronary artery disease and cardiovascular outcome in women: the National Heart, Lung, and Blood Institute-Sponsored Women’s Ischemia Syndrome Evaluation (WISE). Circulation. 2004;109:726–32.CrossRefPubMed Johnson BD, Kip KE, Marroquin OC, Ridker PM, Kelsey SF, Shaw LJ, et al. Serum amyloid A as a predictor of coronary artery disease and cardiovascular outcome in women: the National Heart, Lung, and Blood Institute-Sponsored Women’s Ischemia Syndrome Evaluation (WISE). Circulation. 2004;109:726–32.CrossRefPubMed
57.
go back to reference Lee KWJ, Hill JS, Walley KR, Frohlich JJ. Relative value of multiple plasma biomarkers as risk factors for coronary artery disease and death in an angiography cohort. CMAJ. 2006;174:461–6.PubMed Lee KWJ, Hill JS, Walley KR, Frohlich JJ. Relative value of multiple plasma biomarkers as risk factors for coronary artery disease and death in an angiography cohort. CMAJ. 2006;174:461–6.PubMed
58.
go back to reference Brea D, Sobrino T, Blanco M, Fraga M, Agulla J, Rodriguez-Yanez M, et al. Usefulness of haptoglobin and serum amyloid A proteins as biomarkers for atherothrombotic ischemic stroke diagnosis confirmation. Atherosclerosis. 2009;205:561–7.CrossRefPubMed Brea D, Sobrino T, Blanco M, Fraga M, Agulla J, Rodriguez-Yanez M, et al. Usefulness of haptoglobin and serum amyloid A proteins as biomarkers for atherothrombotic ischemic stroke diagnosis confirmation. Atherosclerosis. 2009;205:561–7.CrossRefPubMed
59.
go back to reference Rallidis LS, Vikelis M, Panagiotakos DB, Rizos I, Zolindaki MG, Kaliva K, et al. Inflammatory markers and in-hospital mortality in acute ischaemic stroke. Atherosclerosis. 2006;189:193–7.CrossRefPubMed Rallidis LS, Vikelis M, Panagiotakos DB, Rizos I, Zolindaki MG, Kaliva K, et al. Inflammatory markers and in-hospital mortality in acute ischaemic stroke. Atherosclerosis. 2006;189:193–7.CrossRefPubMed
60.
go back to reference Wohlin M, Helmersson J, Sundstrom J, Arnlov J, Vessby B, Larsson A, et al. Both cyclooxygenase- and cytokine-mediated inflammation are associated with carotid intima-media thickness. Cytokine. 2007;38:130–6.CrossRefPubMed Wohlin M, Helmersson J, Sundstrom J, Arnlov J, Vessby B, Larsson A, et al. Both cyclooxygenase- and cytokine-mediated inflammation are associated with carotid intima-media thickness. Cytokine. 2007;38:130–6.CrossRefPubMed
61.
go back to reference Uurtuya S, Kotani K, Koibuchi H, Taniguchi N, Yamada T. Serum amyloid A protein and carotid intima-media thickness in healthy young subjects. J Atheroscler Thromb. 2009;16:299–300.PubMed Uurtuya S, Kotani K, Koibuchi H, Taniguchi N, Yamada T. Serum amyloid A protein and carotid intima-media thickness in healthy young subjects. J Atheroscler Thromb. 2009;16:299–300.PubMed
62.
go back to reference Maier W, Altwegg LA, Corti R, Gay S, Hersberger M, Maly FE, et al. Inflammatory markers at the site of ruptured plaque in acute myocardial infarction: locally increased interleukin-6 and serum amyloid A but decreased C-reactive protein. Circulation. 2005;111:1355–61.CrossRefPubMed Maier W, Altwegg LA, Corti R, Gay S, Hersberger M, Maly FE, et al. Inflammatory markers at the site of ruptured plaque in acute myocardial infarction: locally increased interleukin-6 and serum amyloid A but decreased C-reactive protein. Circulation. 2005;111:1355–61.CrossRefPubMed
63.
go back to reference Ley SH, Harris SB, Connelly PW, Mamakeesick M, Gittelsohn J, Hegele RA, et al. Adipokines and incident type 2 diabetes in an aboriginal Canadian corrected population: the Sandy Lake Health and Diabetes Project. Diabetes Care. 2008;31:1410–5.CrossRefPubMed Ley SH, Harris SB, Connelly PW, Mamakeesick M, Gittelsohn J, Hegele RA, et al. Adipokines and incident type 2 diabetes in an aboriginal Canadian corrected population: the Sandy Lake Health and Diabetes Project. Diabetes Care. 2008;31:1410–5.CrossRefPubMed
64.
go back to reference Pitsavos C, Tampourlou M, Panagiotakos DB, Skoumas Y, Chrysohoou C, Nomikos T, et al. Association between low-grade systemic inflammation and type 2 diabetes mellitus among men and women from the ATTICA study. Rev Diabet Stud. 2007;4:98–104.CrossRefPubMed Pitsavos C, Tampourlou M, Panagiotakos DB, Skoumas Y, Chrysohoou C, Nomikos T, et al. Association between low-grade systemic inflammation and type 2 diabetes mellitus among men and women from the ATTICA study. Rev Diabet Stud. 2007;4:98–104.CrossRefPubMed
65.
go back to reference Herder C, Peltonen M, Koenig W, Kraft I, Muller-Scholze S, Martin S, et al. Systemic immune mediators and lifestyle changes in the prevention of type 2 diabetes: results from the Finnish Diabetes Prevention Study. Diabetes. 2006;55:2340–6.CrossRefPubMed Herder C, Peltonen M, Koenig W, Kraft I, Muller-Scholze S, Martin S, et al. Systemic immune mediators and lifestyle changes in the prevention of type 2 diabetes: results from the Finnish Diabetes Prevention Study. Diabetes. 2006;55:2340–6.CrossRefPubMed
66.
go back to reference Ebeling P, Teppo AM, Koistinen HA, Viikari J, Ronnemaa T, Nissen M, et al. Troglitazone reduces hyperglycaemia and selectively acute-phase serum proteins in patients with Type II diabetes. Diabetologia. 1999;42:1433–8.CrossRefPubMed Ebeling P, Teppo AM, Koistinen HA, Viikari J, Ronnemaa T, Nissen M, et al. Troglitazone reduces hyperglycaemia and selectively acute-phase serum proteins in patients with Type II diabetes. Diabetologia. 1999;42:1433–8.CrossRefPubMed
67.
go back to reference Ghanim H, Dhindsa S, Aljada A, Chaudhuri A, Viswanathan P, Dandona P. Low-dose rosiglitazone exerts an antiinflammatory effect with an increase in adiponectin independently of free fatty acid fall and insulin sensitization in obese type 2 diabetics. J Clin Endocrinol Metab. 2006;91:3553–8.CrossRefPubMed Ghanim H, Dhindsa S, Aljada A, Chaudhuri A, Viswanathan P, Dandona P. Low-dose rosiglitazone exerts an antiinflammatory effect with an increase in adiponectin independently of free fatty acid fall and insulin sensitization in obese type 2 diabetics. J Clin Endocrinol Metab. 2006;91:3553–8.CrossRefPubMed
68.
go back to reference Lago F, Dieguez C, Gomez-Reino J, Gualillo O. Adipokines as emerging mediators of immune response and inflammation. Nat Clin Pract Rheumatol. 2007;3:716–24.CrossRefPubMed Lago F, Dieguez C, Gomez-Reino J, Gualillo O. Adipokines as emerging mediators of immune response and inflammation. Nat Clin Pract Rheumatol. 2007;3:716–24.CrossRefPubMed
69.
go back to reference Tilg H, Moschen AR. Adipocytokines: mediators linking adipose tissue, inflammation and immunity. Nat Rev Immunol. 2006;6:772–83.CrossRefPubMed Tilg H, Moschen AR. Adipocytokines: mediators linking adipose tissue, inflammation and immunity. Nat Rev Immunol. 2006;6:772–83.CrossRefPubMed
70.
go back to reference Berg AH, Scherer PE. Adipose tissue, inflammation, and cardiovascular disease. Circ Res. 2005;96:939–49.CrossRefPubMed Berg AH, Scherer PE. Adipose tissue, inflammation, and cardiovascular disease. Circ Res. 2005;96:939–49.CrossRefPubMed
71.
go back to reference Lin Y, Rajala MW, Berger JP, Moller DE, Barzilai N, Scherer PE. Hyperglycemia-induced production of acute phase reactants in adipose tissue. J Biol Chem. 2001;276:42077–83.CrossRefPubMed Lin Y, Rajala MW, Berger JP, Moller DE, Barzilai N, Scherer PE. Hyperglycemia-induced production of acute phase reactants in adipose tissue. J Biol Chem. 2001;276:42077–83.CrossRefPubMed
72.
go back to reference Subramanian S, Han CY, Chiba T, McMillen TS, Wang SA, Haw A III et al. Dietary cholesterol worsens adipose tissue macrophage accumulation and atherosclerosis in obese LDL receptor-deficient mice. Arterioscler Thromb Vasc Biol. 2008;28:685–91.CrossRefPubMed Subramanian S, Han CY, Chiba T, McMillen TS, Wang SA, Haw A III et al. Dietary cholesterol worsens adipose tissue macrophage accumulation and atherosclerosis in obese LDL receptor-deficient mice. Arterioscler Thromb Vasc Biol. 2008;28:685–91.CrossRefPubMed
73.
go back to reference Chiba T, Han CY, Vaisar T, Shimokado K, Kargi A, Chen M-H, et al. Serum amyloid A3 does not contribute to circulating SAA levels. J Lipid Res. 2009;50:1353–62.CrossRefPubMed Chiba T, Han CY, Vaisar T, Shimokado K, Kargi A, Chen M-H, et al. Serum amyloid A3 does not contribute to circulating SAA levels. J Lipid Res. 2009;50:1353–62.CrossRefPubMed
74.
go back to reference Lewis KE, Kirk EA, McDonald TO, Wang S, Wight TN, O’Brien KD, et al. Increase in serum amyloid A evoked by dietary cholesterol is associated with increased atherosclerosis in mice. Circulation. 2004;110:540–5.CrossRefPubMed Lewis KE, Kirk EA, McDonald TO, Wang S, Wight TN, O’Brien KD, et al. Increase in serum amyloid A evoked by dietary cholesterol is associated with increased atherosclerosis in mice. Circulation. 2004;110:540–5.CrossRefPubMed
75.
go back to reference Kim F, Pham M, Maloney E, Rizzo NO, Morton GJ, Wisse BE, et al. Vascular inflammation, insulin resistance, and reduced nitric oxide production precede the onset of peripheral insulin resistance. Arterioscler Thromb Vasc Biol. 2008;28:1982–8.CrossRefPubMed Kim F, Pham M, Maloney E, Rizzo NO, Morton GJ, Wisse BE, et al. Vascular inflammation, insulin resistance, and reduced nitric oxide production precede the onset of peripheral insulin resistance. Arterioscler Thromb Vasc Biol. 2008;28:1982–8.CrossRefPubMed
76.
go back to reference Ye XY, Xue YM, Sha JP, Li CZ, Zhen ZJ. Serum amyloid A attenuates cellular insulin sensitivity by increasing JNK activity in 3T3–L1 adipocytes. J Endocrinol Invest. 2009;32:568–75.PubMed Ye XY, Xue YM, Sha JP, Li CZ, Zhen ZJ. Serum amyloid A attenuates cellular insulin sensitivity by increasing JNK activity in 3T3–L1 adipocytes. J Endocrinol Invest. 2009;32:568–75.PubMed
77.
go back to reference Arner P. Control of lipolysis and its relevance to development of obesity in man. Diabetes Metab Rev. 1988;4:507–15.CrossRefPubMed Arner P. Control of lipolysis and its relevance to development of obesity in man. Diabetes Metab Rev. 1988;4:507–15.CrossRefPubMed
78.
go back to reference Chen CH, Wang PH, Liu BH, Hsu HH, Mersmann HJ, Ding ST. Serum amyloid A protein regulates the expression of porcine genes related to lipid metabolism. J Nutr. 2008;138:674–9.PubMed Chen CH, Wang PH, Liu BH, Hsu HH, Mersmann HJ, Ding ST. Serum amyloid A protein regulates the expression of porcine genes related to lipid metabolism. J Nutr. 2008;138:674–9.PubMed
79.
go back to reference Marx N, Froehlich J, Siam L, Ittner J, Wierse G, Schmidt A, et al. Antidiabetic PPAR gamma-activator rosiglitazone reduces MMP-9 serum levels in type 2 diabetic patients with coronary artery disease. Arterioscler Thromb Vasc Biol. 2003;23:283–8.CrossRefPubMed Marx N, Froehlich J, Siam L, Ittner J, Wierse G, Schmidt A, et al. Antidiabetic PPAR gamma-activator rosiglitazone reduces MMP-9 serum levels in type 2 diabetic patients with coronary artery disease. Arterioscler Thromb Vasc Biol. 2003;23:283–8.CrossRefPubMed
80.
go back to reference Hetzel J, Balletshofer B, Rittig K, Walcher D, Kratzer W, Hombach V, et al. Rapid effects of rosiglitazone treatment on endothelial function and inflammatory biomarkers. Arterioscler Thromb Vasc Biol. 2005;25:1804–9.CrossRefPubMed Hetzel J, Balletshofer B, Rittig K, Walcher D, Kratzer W, Hombach V, et al. Rapid effects of rosiglitazone treatment on endothelial function and inflammatory biomarkers. Arterioscler Thromb Vasc Biol. 2005;25:1804–9.CrossRefPubMed
81.
go back to reference Mohanty P, Aljada A, Ghanim H, Hofmeyer D, Tripathy D, Syed T, et al. Evidence for a potent antiinflammatory effect of rosiglitazone. J Clin Endocrinol Metab. 2004;89:2728–35.CrossRefPubMed Mohanty P, Aljada A, Ghanim H, Hofmeyer D, Tripathy D, Syed T, et al. Evidence for a potent antiinflammatory effect of rosiglitazone. J Clin Endocrinol Metab. 2004;89:2728–35.CrossRefPubMed
82.
go back to reference Chaudhuri A, Janicke D, Wilson MF, Tripathy D, Garg R, Bandyopadhyay A et al. Anti-inflammatory and profibrinolytic effect of insulin in acute ST-segment-elevation myocardial infarction. Circulation. 2004;109:849–54.CrossRefPubMed Chaudhuri A, Janicke D, Wilson MF, Tripathy D, Garg R, Bandyopadhyay A et al. Anti-inflammatory and profibrinolytic effect of insulin in acute ST-segment-elevation myocardial infarction. Circulation. 2004;109:849–54.CrossRefPubMed
83.
go back to reference Zadelaar ASM, Boesten LSM, Jukema JW, van Vlijmen BJM, Kooistra T, Emeis JJ, et al. Dual PPARalpha/gamma agonist tesaglitazar reduces atherosclerosis in insulin-resistant and hypercholesterolemic ApoE*3Leiden mice. Arterioscler Thromb Vasc Biol. 2006;26:2560–6.CrossRefPubMed Zadelaar ASM, Boesten LSM, Jukema JW, van Vlijmen BJM, Kooistra T, Emeis JJ, et al. Dual PPARalpha/gamma agonist tesaglitazar reduces atherosclerosis in insulin-resistant and hypercholesterolemic ApoE*3Leiden mice. Arterioscler Thromb Vasc Biol. 2006;26:2560–6.CrossRefPubMed
84.
go back to reference Kinlay S, Schwartz GG, Olsson AG, Rifai N, Leslie SJ, Sasiela WJ, et al. High-dose atorvastatin enhances the decline in inflammatory markers in patients with acute coronary syndromes in the MIRACL study. Circulation. 2003;108:1560–6.CrossRefPubMed Kinlay S, Schwartz GG, Olsson AG, Rifai N, Leslie SJ, Sasiela WJ, et al. High-dose atorvastatin enhances the decline in inflammatory markers in patients with acute coronary syndromes in the MIRACL study. Circulation. 2003;108:1560–6.CrossRefPubMed
85.
go back to reference Schillinger M, Exner M, Mlekusch W, Amighi J, Sabeti S, Muellner M, et al. Statin therapy improves cardiovascular outcome of patients with peripheral artery disease. Eur Heart J. 2004;25:742–8.CrossRefPubMed Schillinger M, Exner M, Mlekusch W, Amighi J, Sabeti S, Muellner M, et al. Statin therapy improves cardiovascular outcome of patients with peripheral artery disease. Eur Heart J. 2004;25:742–8.CrossRefPubMed
86.
go back to reference Kleemann R, Princen HMG, Emeis JJ, Jukema JW, Fontijn RD, Horrevoets AJG, et al. Rosuvastatin reduces atherosclerosis development beyond and independent of its plasma cholesterol-lowering effect in APOE*3-Leiden transgenic mice: evidence for antiinflammatory effects of rosuvastatin. Circulation. 2003;108:1368–74.CrossRefPubMed Kleemann R, Princen HMG, Emeis JJ, Jukema JW, Fontijn RD, Horrevoets AJG, et al. Rosuvastatin reduces atherosclerosis development beyond and independent of its plasma cholesterol-lowering effect in APOE*3-Leiden transgenic mice: evidence for antiinflammatory effects of rosuvastatin. Circulation. 2003;108:1368–74.CrossRefPubMed
87.
go back to reference Verschuren L, Kleemann R, Offerman EH, Szalai AJ, Emeis SJ, Princen HMG, et al. Effect of low dose atorvastatin versus diet-induced cholesterol lowering on atherosclerotic lesion progression and inflammation in apolipoprotein E*3-Leiden transgenic mice. Arterioscler Thromb Vasc Biol. 2005;25:161–7.PubMed Verschuren L, Kleemann R, Offerman EH, Szalai AJ, Emeis SJ, Princen HMG, et al. Effect of low dose atorvastatin versus diet-induced cholesterol lowering on atherosclerotic lesion progression and inflammation in apolipoprotein E*3-Leiden transgenic mice. Arterioscler Thromb Vasc Biol. 2005;25:161–7.PubMed
88.
go back to reference Derosa G, Tinelli C, Maffioli P. Effects of pioglitazone and rosiglitazone combined with metformin on body weight in people with diabetes. Diabetes Obes Metab. 2009;11:1091–9.CrossRefPubMed Derosa G, Tinelli C, Maffioli P. Effects of pioglitazone and rosiglitazone combined with metformin on body weight in people with diabetes. Diabetes Obes Metab. 2009;11:1091–9.CrossRefPubMed
Metadata
Title
Association between serum amyloid A and obesity: a meta-analysis and systematic review
Authors
Yulan Zhao
Xuelian He
Xuegui Shi
Chengjin Huang
Jie Liu
Shuli Zhou
Chew-Kiat Heng
Publication date
01-05-2010
Publisher
SP Birkhäuser Verlag Basel
Published in
Inflammation Research / Issue 5/2010
Print ISSN: 1023-3830
Electronic ISSN: 1420-908X
DOI
https://doi.org/10.1007/s00011-010-0163-y

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