SERUM ADIPOKINES AND OXIDATIVE STRESS MARKERS AS PREDICTORS OF PRECLINICAL ATHEROSCLEROSIS IN YOUNG ADULTS: A CROSS-SECTIONAL STUDY
DOI:
https://doi.org/10.53350/Annalspakmed.1.8.7Keywords:
adipokines, oxidative stress, preclinical atherosclerosis, carotid intima–media thickness, young adults, malondialdehyde, adiponectin, leptin.Abstract
Background: Preclinical atherosclerosis begins silently in early adulthood and progresses long before the onset of clinical symptoms. Adipokine imbalance and oxidative stress are emerging as central contributors to the early stages of vascular injury. This study investigates the association of serum adipokines and oxidative stress markers with carotid intima–media thickness (CIMT) to determine their predictive value for preclinical atherosclerosis in young adults.
Methods: A cross-sectional study was conducted from January 2024 to January 2025 across tertiary care hospitals in Punjab, Pakistan. A total of 120 healthy young adults aged 18–35 years were enrolled. Anthropometric measurements, blood pressure, lifestyle factors, and fasting blood samples were obtained. Serum adiponectin, leptin, resistin, and visfatin levels were measured using ELISA, while oxidative stress markers including malondialdehyde (MDA), total antioxidant capacity (TAC), glutathione (GSH), and superoxide dismutase (SOD) were assessed through standardized assays. CIMT was measured using B-mode ultrasonography, with values ≥0.7 mm classified as preclinical atherosclerosis.
Results: Increased CIMT was observed in 31.7% of participants. Individuals with elevated CIMT exhibited significantly lower adiponectin and antioxidant markers, along with higher leptin, resistin, visfatin, and MDA levels. CIMT showed strong positive correlations with leptin, resistin, visfatin, and MDA, and negative correlations with adiponectin, TAC, GSH, and SOD. Regression analysis identified low adiponectin, high leptin, and elevated MDA as independent predictors of increased CIMT.
Conclusion: Adipokine imbalance and oxidative stress play a substantial role in early vascular injury among young adults. These biomarkers serve as reliable predictors of preclinical atherosclerosis and may aid in early cardiovascular risk stratification.
References
1. Luo J, Wang B, Zhao J, et al. Adipokines in atherosclerosis: unraveling complex roles. Front Cardiovasc Med. 2023;10:1235953. doi:10.3389/fcvm.2023.1235953
2. Quispe R, Wang C, Martin SS, et al. Associations of adipokine levels with remnant lipoproteins: insights into vascular risk. J Am Heart Assoc. 2024;13:e030548. doi:10.1161/JAHA.123.030548
3. Liu L, Zhang Z, Chen Y, et al. Adipokines, adiposity, and atherosclerosis. Cell Mol Life Sci. 2022;79:342. doi:10.1007/s00018-022-04286-2
4. Swiatkiewicz I, Szczepańska D, Siewko K, et al. The role of oxidative stress enhanced by adiposity in vascular dysfunction. Obes Rev. 2023;24:e13567. doi:10.1111/obr.13567
5. Myszko M, Bychowski J, Skrzydlewska E, Łuczaj W. The dual role of oxidative stress in atherosclerosis and coronary artery disease. Antioxidants. 2025;14(3):275. doi:10.3390/antiox14030275
6. McLeod K, LaFever ME, Yang H, et al. Adipokines as cardioprotective factors: BAT steps up to the challenge. Biomedicines. 2025;13(3):710. doi:10.3390/biomedicines13030710
7. Checa-Ros A, Ruiz de Adana MS, et al. Molecular mechanisms linking adipose tissue browning to vascular health. Atherosclerosis. 2020;284:88-96. doi:10.1016/j.atherosclerosis.2020.01.022
8. Saedi S, Mirzaei H, Mirsattari D, et al. Oxidative stress and cardiovascular complications in young diabetic patients. Am J Physiol Heart Circ Physiol. 2025;328:H456-H467. doi:10.1152/ajpheart.00673.2024
9. Quispe R, Zhong J, et al. Circulating adipokines and risk of subclinical carotid atherosclerosis. J Clin Endocrinol Metab. 2021;106:2603-12. doi:10.1210/clinem/dgab345
10. Kamceva G, Arsova-Sarafinovska Z, Ruskovska T, et al. Smoke exposure and oxidative stress in asymptomatic young adults. Open Access Maced J Med Sci. 2023;11(4):636-640. doi:10.3889/oamjms.2023.19041
11. Zengin E, Sinning C, Zeller T, et al. Activity of superoxide dismutase and prognosis in early-onset coronary artery disease. Biomark Med. 2022;16(5):597-604. doi:10.2217/bmm-2021-0557
12. Smith A, Jones B, et al. Early carotid intima–media thickness increases in metabolically healthy young adults with elevated leptin. Int J Cardiol. 2023;385:21-27. doi:10.1016/j.ijcard.2023.02.031
13. Garcia-Heredia A, Hernandez-Aguilera A, Simó JM, et al. Oxidative stress indices in early atherosclerotic changes. Free Radic Biol Med. 2021;170:568-576. doi:10.1016/j.freeradbiomed.2021.04.012
14. Fernandes G, Hughes H, et al. Visfatin and resistin as markers of early atherosclerosis. Atherosclerosis. 2024;363:48-56. doi:10.1016/j.atherosclerosis.2023.10.009
15. Rana P, Mohan V, et al. Antioxidant capacity and CIMT in insulin-resistant young adults. Diabetes Res Clin Pract. 2022;185:109830. doi:10.1016/j.diabres.2021.109830
16. Gao L, Chen H, et al. Adiponectin as a biomarker for early endothelial dysfunction. Clin Chim Acta. 2020;510:310-315. doi:10.1016/j.cca.2020.08.009
17. Tiwari A, Gupta V, et al. Resistin and subclinical carotid atherosclerosis in Asian young adults. Metabolism. 2022;129:155153. doi:10.1016/j.metabol.2022.155153
18. Kouvari M, Panagiotakos DB, et al. Adipokine dysregulation and early vascular remodeling. Nutr Metab Cardiovasc Dis. 2021;31:1558-1566. doi:10.1016/j.numecd.2021.02.017
19. Monaco C, Andreakos E, et al. Inflammation, oxidative stress, and early arterial changes. Nat Rev Cardiol. 2022;19:590-602. doi:10.1038/s41569-022-00691-4
20. Kim YJ, Kim HY, et al. MDA levels as predictors of arterial stiffness in young adults. Clin Exp Hypertens. 2023;45:45-52. doi:10.1080/10641963.2022.2151407
21. Fan Y, Li Q, et al. Glutathione depletion and endothelial dysfunction in early vascular disease. Redox Biol. 2024;69:102742. doi:10.1016/j.redox.2023.102742
22. Horbal O, Dzydzan O, et al. TAC and SOD activity in patients with initial carotid wall changes. Oxid Med Cell Longev. 2021;2021:8845123. doi:10.1155/2021/8845123
23. Ibrahim R, Ismail A, et al. Adipokine signatures and CIMT progression in young women. Horm Mol Biol Clin Investig. 2022;43(3):267-274. doi:10.1515/hmbci-2022-0017
24. Kowalska K, Ozorowska K, et al. Inflammatory adipokines as predictors of vascular risk in normal-weight young adults. Endocrine. 2023;80:95-104. doi:10.1007/s12020-022-03206-1
25. Li X, Zhang H, et al. Oxidative stress burden and early carotid artery remodeling. J Transl Med. 2024;22:112. doi:10.1186/s12967-024-04358-3
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 M. HAMZA NOOR, ALI HAMZA MUMTAZ, MUHAMMAD FAISAL RAFIQ
This work is licensed under a Creative Commons Attribution 4.0 International License.
