Biochemical and Genetic Determinants of Early Cardiovascular and Hepatic Dysfunction: A Focus on ADIPOQ Expression

OBJECTIVE Non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease (CVD) frequently coexist due to common metabolic dysfunctions such as insulin resistance, chronic inflammation, and dyslipidemia. Adipo-nectin, encoded by the ADIPOQ gene, is an anti-inflammatory adipokine vital for glucose and lipid regulation. Reduced adiponectin levels and certain ADIPOQ gene variants (e.g., rs266729, rs2241766) have been linked to both NAFLD and CVD progression. This study aims to evaluate the association between ADIPOQ gene expression and early biochemical markers of hepatic and cardiovascular dysfunction. METHODS A case-control study (n = 300) was conducted in Thiruvananthapuram, Kerala, India (2022-2024), analyzing blood samples for fasting blood sugar (FBS), lipid profile, malondialdehyde (MDA), interleukin-6 (IL-6), and ADIPOQ expression (RT-PCR). Statistical analyses included receiver operating characteristic (ROC) curves and quantile regression using Stata 17.0. RESULTS Cases exhibited significantly elevated FBS, triglycerides (TG), low-density lipoprotein (LDL), MDA, and IL-6, along with reduced high- density lipoprotein (HDL) and adiponectin levels (p < 0.05). ADIPOQ gene expression was markedly downregulated, particularly in individuals with both NAFLD and CVD. A positive correlation was observed between ADIPOQ expression and HDL, and a negative correlation with IL-6. Reduced ADIPOQ expression showed an association with risk in unadjusted analysis, but this association was not statistically significant after adjustment (OR = 0.0220). Nevertheless, ROC analysis indicated potential diagnostic utility. CONCLUSIONS Reduced ADIPOQ expression is significantly associated with early metabolic and inflammatory markers in NAFLD and CVD. These findings highlight the potential utility of ADIPOQ as a biomarker for early detection and targeted prevention strategies in at-risk populations.