Original investigation
The role of mediastinal adipose tissue 11β-hydroxysteroid d ehydrogenase type 1 and glucocorticoid expression in the development of coronary atherosclerosis in obese patients with ischemic heart disease
1 Department Growth-Development and Pediatric Endocrinology, Child Health Institute, Istanbul University, Istanbul, Turkey
2 Department of Cardiology, Acibadem Kadikoy Hospital, Istanbul, Turkey
3 Department of Cardiovascular Surgery, Istanbul Bilim University, Istanbul, Turkey
4 Department of Medical Biology and Genetics, Istanbul Bilim University, Istanbul, Turkey
5 Department of Histology and Embryology, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey
6 Department of Immunology, Institute for Experimental Medical Research, Istanbul University, Istanbul, Turkey
7 Biochemistry Laboratory, Florence Nightingale Hospital, Istanbul, Turkey
8 Department of Radiology, Istanbul Bilim University, Istanbul, Turkey
9 Department of Genetics, Institute for Experimental Medical Research, Istanbul University, Istanbul, Turkey
10 Emeritus, Department of Internal Medicine, Section of Diabetes and Allied Disorders, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
11 Department of Pharmacology, Istanbul Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey
Cardiovascular Diabetology 2012, 11:115 doi:10.1186/1475-2840-11-115
Published: 25 September 2012Abstract
Background
Visceral fat deposition and its associated atherogenic complications are mediated by glucocorticoids. Cardiac visceral fat comprises mediastinal adipose tissue (MAT) and epicardial adipose tissue (EAT), and MAT is a potential biomarker of risk for obese patients.
Aim
Our objective was to evaluate the role of EAT and MAT 11beta-hydroxysteroid dehydrogenase type 1 (11β-HSD-1) and glucocorticoid receptor (GCR) expression in comparison with subcutaneous adipose tissue (SAT) in the development of coronary atherosclerosis in obese patients with coronary artery disease (CAD), and to assess their correlations with CD68 and fatty acids from these tissues.
Methods and results
Expression of 11β-HSD-1 and GCR was measured by qRT-PCR in EAT, MAT and SAT of thirty-one obese patients undergoing coronary artery bypass grafting due to CAD (obese CAD group) and sixteen obese patients without CAD undergoing heart valve surgery (controls). 11β-HSD-1 and GCR expression in MAT were found to be significantly increased in the obese CAD group compared with controls (p < 0.05). In the obese CAD group, 11β-HSD-1 and GCR mRNA levels were strongly correlated in MAT. Stearidonic acid was significantly increased in EAT and MAT of the obese CAD group and arachidonic acid was significantly expressed in MAT of the obese male CAD group (p < 0.05).
Conclusions
We report for the first time the increased expression of 11β-HSD-1 and GCR in MAT compared with EAT and SAT, and also describe the interrelated effects of stearidonic acid, HOMA-IR, plasma cortisol and GCR mRNA levels, explaining 40.2% of the variance in 11β-HSD-1 mRNA levels in MAT of obese CAD patients. These findings support the hypothesis that MAT contributes locally to the development of coronary atherosclerosis via glucocorticoid action.
