Background: Chemerin is a novel adipokine linked with obesity, metabolic syndrome and chronic inflammatory diseases. It plays a pivotal role in modulating adipocyte differentiation, activation of macrophages and production of proinflammatory cytokines. It is hypothesized that chemerin promotes vascular remodeling and endothelial dysfunction leading to the development of coronary atherosclerosis. We conducted a meta-analysis to evaluate the relationship between serum chemerin levels and coronary heart disease (CHD).
Methods: We searched MEDLINE, CINAHL and COCHRANE databases for studies reporting serum chemerin levels in the patients with CHD and healthy controls. We included case controls, cohort and cross-sectional studies. We calculated the weighted standardized mean difference (SMD) in serum chemerin levels between the CHD and control groups.We performed residual maximum likelihood meta-regression analysis on covariates age, BMI and female sex.
Results: Our search strategy yielded 43 articles and we included 10 studies enrolling 2225 participants. The median age and body mass index(BMI) of the CHD group was 62 yrs (IQR 60-63) and 26 kg/m2 (IQR 26-28) vs 61 yrs (IQR 58-62) and 26 kg/m2 (IQR 24-27) in the control group. The median percentage of female population was lower in the CHD group at 39% (IQR 22-52) vs 49% (IQR 31-53) in the control group. The unweighted median serum chemerin levels in the CHD group were 33.3 ng/ml (IQR 25.4-63.2) compared to 29.8 ng/ml (IQR 15.2-38.2) in the control group. The SMD of serum chemerin level was 0.78 (95% CI 0.39 - 1.17) P<0.001 comparing those in the CHD group and control group. This association was not explained by age, BMI or sex.
Conclusion: An elevated serum chemerin level is significantly associated with presence of CHD. Chemerin can potentially used as a novel biomarker and to risk stratify patients with CHD.