Association between serum amyloid A and obesity: A meta-analysis and systematic review

Abstract

Background Emerging evidence indicates an association of the acute-phase protein serum amyloid A (SAA) with obesity. Here we review and summarize quantitatively the available data related to this association. Methods PubMed was systematically searched using the terms "serum amyloid A" and "obesity." Eighty-one relevant studies between January 1966 and July 2009 were identified. Of these, only 11 cross-sectional studies and 10 prospective studies with successful interventions met our inclusion criteria for the meta-analysis. All analyses were conducted using the Comprehensive Meta-Analysis software. Literature pertaining to the relationship between SAA and other inflammatory markers, and the association between SAA and obesity-related disorders, such as cardiovascular diseases, atherosclerosis, diabetes, and insulin resistance was also reviewed. Results A strong association between body mass index and SAA levels was found in the 11 cross-sectional studies. The overall correlation coefficient is 0.230 (95% CI 0.160-0.297, P<0.0005). The ten prospective studies were subsequently analyzed, and the difference in SAA levels before and after weight loss, expressed as standardized mean difference was-0.480 (95% CI-0.678 to-0.283, P<0.0005). We discuss some potential underlying mechanisms and clinical applications for reducing SAA levels in obesity. © 2009 Birkhäuser Verlag, Basel/Switzerland.