Relationship of serum kallistatin levels with carotis intima-media thickness and cardiovasculer markers in adult obese individuals

With the increase in the obese population in the society, obesity emerges as an important health problem. Cardiovascular events have an important place among the complications caused by obesity. In recent years, the search for biochemical markers that can be used in the determination and follow-up of cardiovascular risk caused by obesity has been the subject of many studies. Kallistatin has been identified in human plasma as a tissue kallikrein binding protein and a serine proteinase inhibitor. It has two different sites of action: heparin-binding and active moiety. Thanks to these sites of action, it acts on many pathways and reduces oxidative stress. Its levels have been reported to be significantly reduced in patients with coronary artery disease, sepsis, inflammatory bowel disease, pneumonia and cancer. In our study, we aimed to investigate the relationship between serum kallistatin levels and carotid media intima thickness and cardiovascular risk markers in obese patients. In our study, 45 obese patients over 18 years of age with a body mass index of 30 and above and 41 healthy individuals with a body mass index of 20-25 were included. Patients with documented acute coronary syndrome which is in the last six months, heart failure, coronary artery disease, malignancy, active infection, and chronic liver disease were not included in the study. Serum kallistatin level was found to be statistically significantly lower in the obese patient group (p=0.003). It was determined that the increase in serum kallistatin levels decreased the probability of obesity diagnosis ((AUC: Accuracy) 0.688 (95% CI: 0.572-0.795 p=0.003) The optimum cut-off value for kallistatin was determined as 2469.763 pg/ml sensitivity = % 45.2, specificity =88.6%. There was a negative correlation between kallistatin levels and insulin, HOMA-IR, carotid media intima thickness, weight, waist circumference, hip circumference, waist/height ratio and body mass index, fat weight, fat ratio and basal metabolic rate. Carotid media intima thickness was found to be an independent risk factor in determining serum kallistatin levels. There was no correlation between serum kallistatin levels and Hs-CRP, HDL, VLDL, LDL, triglyceride, total cholesterol and fibrinogen. As a result, we think that more studies are needed to use serum kallistatin levels as a new marker for the diagnosis of obesity and determining cardiovascular risk.