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Review
. 2015 Mar 20;10(3):e0120419.
doi: 10.1371/journal.pone.0120419. eCollection 2015.

Association between resistin levels and all-cause and cardiovascular mortality: a new study and a systematic review and meta-analysis

Andrea Fontana  1 , Sara Spadaro  2 , Massimiliano Copetti  1 , Belinda Spoto  3 , Lucia Salvemini  4 , Patrizia Pizzini  3 , Lucia Frittitta  5 , Francesca Mallamaci  3 , Fabio Pellegrini  1 , Vincenzo Trischitta  6 , Claudia Menzaghi  4
Affiliations
Review

Association between resistin levels and all-cause and cardiovascular mortality: a new study and a systematic review and meta-analysis

Andrea Fontana et al. PLoS One. .

Abstract

Context: Studies concerning the association between circulating resistin and mortality risk have reported, so far, conflicting results.

Objective: To investigate the association between resistin and both all-cause and cardiovascular (CV) mortality risk by 1) analyzing data from the Gargano Heart Study (GHS) prospective design (n=359 patients; 81 and 58 all-cause and CV deaths, respectively); 2) performing meta-analyses of all published studies addressing the above mentioned associations.

Data source and study selection: MEDLINE and Web of Science search of studies reporting hazard ratios (HR) of circulating resistin for all-cause or CV mortality.

Data extraction: Performed independently by two investigators, using a standardized data extraction sheet.

Data synthesis: In GHS, adjusted HRs per one standard deviation (SD) increment in resistin concentration were 1.28 (95% CI: 1.07-1.54) and 1.32 (95% CI: 1.06-1.64) for all-cause and CV mortality, respectively. The meta-analyses included 7 studies (n=4016; 961 events) for all-cause mortality and 6 studies (n=4,187: 412 events) for CV mortality. Pooled HRs per one SD increment in resistin levels were 1.21 (95% CI: 1.03-1.42, Q-test p for heterogeneity<0.001) and 1.05 (95% CI: 1.01-1.10, Q-test p for heterogeneity=0.199) for all-cause and CV mortality, respectively. At meta-regression analyses, study mean age explained 9.9% of all-cause mortality studies heterogeneity. After adjusting for age, HR for all-cause mortality was 1.24 (95% CI: 1.06-1.45).

Conclusions: Our results provide evidence for an association between circulating resistin and mortality risk among high-risk patients as are those with diabetes and coronary artery disease.

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Conflict of interest statement

Competing Interests: This study received funding from European Foundation for the Study of Diabetes/Pfizer and SID-FO.DI.RI grants. There are no patents, products in development, or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Search strategy for selecting studies to include in meta-analyses of resistin and all-cause mortality and cardiovascular mortality (search last run on October 2014).
Fig 2
Fig 2. Forest plot for random-effects meta-analysis (panel A) and bubble plot for random-effects meta-regression with age as study-level covariate (panel B) on all-cause mortality.
Fig 3
Fig 3. Forest plot for random-effects meta-analysis on CV mortality.
See this image and copyright information in PMC

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Grants and funding

This study was supported by Accordo Programma Quadro in Materia di Ricerca Scientifica nella Regione Puglia-PST 2006 and PO Puglia FESR 2007-2013, Italian Ministry of Health grants RC2014 and RC2015, European Foundation for the Study of Diabetes/Pfizer grant and Società Italiana di Diabetologia-Fondazione Diabete Ricerca (CM). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.