Int J Med Sci 2017; 14(3):268-274. doi:10.7150/ijms.17821

Research Paper

Expression of Sterol Regulatory Element-Binding Proteins in epicardial adipose tissue in patients with coronary artery disease and diabetes mellitus: preliminary study

Luis M. Pérez-Belmonte1✉*, Inmaculada Moreno-Santos1*, Fernando Cabrera-Bueno1, Gemma Sánchez-Espín1, Daniel Castellano2, Miguel Such1, María G Crespo-Leiro3, Fernando Carrasco-Chinchilla1, Luis Alonso-Pulpón4, Miguel López-Garrido1, Amalio Ruiz-Salas1, Víctor M. Becerra-Muñoz1, Juan J. Gómez-Doblas1, Eduardo de Teresa-Galván1, Manuel Jiménez-Navarro1✉

1. Unidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga (UMA), CIBERCV Enfermedades Cardiovasculares, Málaga, Spain.
2. Unidad de Gestión Clínica de Endocrinología y Nutrición, Laboratorio del Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario de Málaga (Virgen de la Victoria), Málaga, Spain. CIBER Pathophysiology of obesity and nutrition, Spain.
3. Servicio de Cardiología, Complejo Hospitalario Universitario A Coruña, Instituto de Investigación Biomédica A Coruña (INIBIC), CIBERCV Enfermedades Cardiovasculares, A Coruña. Spain.
4. Servicio de Cardiología, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, CIBERCV Enfermedades Cardiovasculares, Madrid, Spain.
*These authors contributed equally to this work.


Objectives: Sterol regulatory element-binding proteins (SREBP) genes are crucial in lipid biosynthesis and cardiovascular homeostasis. Their expression in epicardial adipose tissue (EAT) and their influence in the development of coronary artery disease (CAD) and type-2 diabetes mellitus remain to be determined. The aim of our study was to evaluate the expression of SREBP genes in EAT in patients with CAD according to diabetes status and its association with clinical and biochemical data.

Methods: SREBP-1 and SREBP-2 mRNA expression levels were measured in EAT from 49 patients with CAD (26 with diabetes) and 23 controls without CAD or diabetes.

Results: Both SREBPs mRNA expression were significantly higher in patients with CAD and diabetes (p<0.001) and were identified as independent cardiovascular risk factor for coronary artery disease in patients with type-2 diabetes (SREBP-1: OR 1.7, 95%CI 1.1-2.5, p=0.02; SREBP-2: OR 1.6, 95%CI 1.2-3, p=0.02) and were independently associated with the presence of multivessel CAD, left main and anterior descending artery stenosis, and higher total and LDL cholesterol levels, and lower HDL cholesterol levels, in patients with CAD and diabetes.

Conclusions: SREBP genes are expressed in EAT and were higher in CAD patients with diabetes than those patients without CAD or diabetes. SREBP expression was associated as cardiovascular risk factor for the severity of CAD and the poor lipid control. In this preliminary study we suggest the importance of EAT in the lipid metabolism and cardiovascular homeostasis for coronary atherosclerosis of patients with diabetes and highlight a future novel therapeutic target.

Keywords: Sterol regulatory element-binding proteins (SREBP), epicardial adipose tissue, coronary artery disease, type-2 diabetes mellitus.

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How to cite this article:
Pérez-Belmonte LM, Moreno-Santos I, Cabrera-Bueno F, Sánchez-Espín G, Castellano D, Such M, Crespo-Leiro MG, Carrasco-Chinchilla F, Alonso-Pulpón L, López-Garrido M, Ruiz-Salas A, Becerra-Muñoz VM, Gómez-Doblas JJ, de Teresa-Galván E, Jiménez-Navarro M. Expression of Sterol Regulatory Element-Binding Proteins in epicardial adipose tissue in patients with coronary artery disease and diabetes mellitus: preliminary study. Int J Med Sci 2017; 14(3):268-274. doi:10.7150/ijms.17821. Available from