Aist-to-hip ratio, glucose, and hsCRP levels [13]. Although the 15900046 reason or these discordant results could not be clarified in the present study, we could suggest several hypotheses to explain this result. First, the paradoxical increase of CTRP3 in the subjects of type 2 diabetes might be originated from a compensatory mechanism to overcome the metabolic stress or resistance. Hormone resistance to the effects of insulin, leptin, and fibroblast growth factor 21 (FGF21) has been reported in diabetes and obesity [27,28]. In our previous study, a subgroup analysis that included only subjects without diabetes showed a similar tendency to the results of this study, although the negative relationship between CTRP3 level and cardiometabolic risk Hypericin factors did not reach a significant level due to the insufficient number of subjects [13]. Secondly, the biological function of CTRP3 can be different according to glucose tolerance status. Kopp et al. showed that CTRP3 reduced the LPS induced release of macrophage migration inhibitor factor in non-diabetic controls, whereas no effects in type 2 diabetic subjects [11]. Lastly, the participants of the previous study included type 2 diabetes, so many people had been taken various kinds of medications which may affect the circulating CTRP3 levels. Further studies to clarify the underlying mechanism for the regulation of CTRP3 should be followed. Interestingly, circulating CTRP3 levels had significant negative correlations with various metabolic risk factors such as waist circumference, diastolic blood pressure, triglycerides, and fasting glucose, whereas serum progranulin levels showed significant positive relationship with inflammatory markers such as hsCRP and IL-6. These results suggest that CTRP3 may be moreProgranulin and CTRP3 in Metabolic Syndromeclosely related with metabolic parameters, whereas progranulin may be more closely associated with inflammatory parameters in humans. There are some limitations to this study. First, because it was a cross-sectional study, no causality could be defined. It is not clear whether circulating progranulin and CTRP3 levels are causative factors or markers of the pathogenesis of inflammatory diseases and atherosclerosis. Secondly, this study enrolled only Asian subjects without diabetes or CVD, so the relationship of serum progranulin and CTRP3 levels to metabolic risk factors should be further evaluated in other ethnic populations and in the context of different interventions for the treatment of diabetes and CVD. Thirdly, the subjects with renal insufficiency, defined as an eGFR ,60 (mL/min/1.73 m2), were very few in this cohort (n = 2). Therefore, to clarify the relationship of renal dysfunction with CTRP3, further studies including the subjects with renal impairment should be followed. Lastly, the data about smoking, alcohol, and exercise were not available in this cohort, so we could not adjust the effect of these lifestyle factors. In conclusion, this study showed that serum progranulin levels had a significant positive relationship with hsCRP and IL-6 concentrations. Furthermore, serum progranulin level was anindependent determining risk factor for CI 1011 custom synthesis carotid atherosclerosis in subjects without metabolic syndrome. On the other hand, circulating CTRP3 concentration had a significant association with cardiometabolic risk factors, such as obesity, glucose levels, lipid parameters, eGFR, and adiponectin levels. Further experimental and prospectively-designed studie.Aist-to-hip ratio, glucose, and hsCRP levels [13]. Although the 15900046 reason or these discordant results could not be clarified in the present study, we could suggest several hypotheses to explain this result. First, the paradoxical increase of CTRP3 in the subjects of type 2 diabetes might be originated from a compensatory mechanism to overcome the metabolic stress or resistance. Hormone resistance to the effects of insulin, leptin, and fibroblast growth factor 21 (FGF21) has been reported in diabetes and obesity [27,28]. In our previous study, a subgroup analysis that included only subjects without diabetes showed a similar tendency to the results of this study, although the negative relationship between CTRP3 level and cardiometabolic risk factors did not reach a significant level due to the insufficient number of subjects [13]. Secondly, the biological function of CTRP3 can be different according to glucose tolerance status. Kopp et al. showed that CTRP3 reduced the LPS induced release of macrophage migration inhibitor factor in non-diabetic controls, whereas no effects in type 2 diabetic subjects [11]. Lastly, the participants of the previous study included type 2 diabetes, so many people had been taken various kinds of medications which may affect the circulating CTRP3 levels. Further studies to clarify the underlying mechanism for the regulation of CTRP3 should be followed. Interestingly, circulating CTRP3 levels had significant negative correlations with various metabolic risk factors such as waist circumference, diastolic blood pressure, triglycerides, and fasting glucose, whereas serum progranulin levels showed significant positive relationship with inflammatory markers such as hsCRP and IL-6. These results suggest that CTRP3 may be moreProgranulin and CTRP3 in Metabolic Syndromeclosely related with metabolic parameters, whereas progranulin may be more closely associated with inflammatory parameters in humans. There are some limitations to this study. First, because it was a cross-sectional study, no causality could be defined. It is not clear whether circulating progranulin and CTRP3 levels are causative factors or markers of the pathogenesis of inflammatory diseases and atherosclerosis. Secondly, this study enrolled only Asian subjects without diabetes or CVD, so the relationship of serum progranulin and CTRP3 levels to metabolic risk factors should be further evaluated in other ethnic populations and in the context of different interventions for the treatment of diabetes and CVD. Thirdly, the subjects with renal insufficiency, defined as an eGFR ,60 (mL/min/1.73 m2), were very few in this cohort (n = 2). Therefore, to clarify the relationship of renal dysfunction with CTRP3, further studies including the subjects with renal impairment should be followed. Lastly, the data about smoking, alcohol, and exercise were not available in this cohort, so we could not adjust the effect of these lifestyle factors. In conclusion, this study showed that serum progranulin levels had a significant positive relationship with hsCRP and IL-6 concentrations. Furthermore, serum progranulin level was anindependent determining risk factor for carotid atherosclerosis in subjects without metabolic syndrome. On the other hand, circulating CTRP3 concentration had a significant association with cardiometabolic risk factors, such as obesity, glucose levels, lipid parameters, eGFR, and adiponectin levels. Further experimental and prospectively-designed studie.
