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Serum vaspin role in atherosclerosis and glucose tolerance disorders: A systematic review and meta-analysis

Rivan Danuaji, Suroto Suroto, Bambang Purwanto, Dono Indarto, Faizal Muhammad, Diah Kurnia Mirawati, Vitri Widyaningsih, Soetrisno Soetrisno, Subandi Subandi, Pepi Budianto, Yetty Hambarsari, Baarid Luqman Hamidi, Hanindia Riani Prabaningtyas, Ervina Arta Jayanti Hutabarat, Ira Ristinawati, Teddy Tejomukti, Raden Andi Ario Tedjo.


Visceral adipose tissue-derived serine protease inhibitor (vaspin) is an adipokine associated with insulin resistance (IR), obesity, and inflammation. Serum vaspin role and significant alteration in its levels in type 2 diabetes mellitus (T2DM) and atherosclerotic disease have been severally reported. Nevertheless, these immense changes and this role have been studied, and different results were observed across several atherosclerosis and glucose tolerance disorders-associated studies due to differences in design, sample size and baseline parameters, and population race. Hence, we performed a systematic review to establish and summarize the latest results of serum vaspin level alteration and its role in atherosclerosis and glucose tolerance disorders. The studies from databases such as PubMed, ScienceDirect, Scopus, and Google Scholar were employed. The keywords included vaspin, atherosclerosis, coronary heart disease, ischemic heart disease, stroke, insulin, diabetes, glucose intolerance, metabolic syndrome, and obesity. Boolean Logic “AND” was used to combine each keyword and specify the results. Twenty-three articles were selected based on the suitability of their title/abstract and the inclusion criteria for this review topic. Two review authors independently evaluated the risk of bias based on the Cochrane risk of bias tool. Furthermore, we used RevMan 5.3 to present and synthesize the results. Critical appraisal of each obtained article showed that high vaspin levels were associated with a lower risk of atherosclerosis. Meanwhile, 10 articles about vaspin and glucose tolerance disorders showed that high vaspin levels were associated with a higher risk of developing T2DM. Meta-analysis showed atherosclerotic diseases and glucose tolerance disorders versus normal healthy (MD −0.43; 95% CI: −1.35 to 0.50 and MD −0.07; 95% CI: −0.38 to 0.25, respectively), which indicated higher vaspin levels in the disease group were favored. High serum vaspin levels in arterial plaque diseases were considered a protective mechanism to prevent further endothelial inflammation, injury, and atherosclerosis. This similar observation was found in obesity or T2DM patients as a compensatory mechanism for IR conditions.

Key words: Vaspin, adipokine, atherosclerosis, diabetes mellitus, insulin resistance, obesity

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