Fasting adiponectin in relation to the metabolic syndrome in patients with coronary artery disease

ABSTRACT

Metabolic syndrome and coronary artery disease [CAD] are increasing worldwide. The relationship between metabolic syndrome and fasting serum adiponectin concentration in CAD patients is not well elucidated. The aim of present study is to explore the relationship between serum adiponectin concentrations and the presence of metabolic syndrome [MetS] among patients with CAD. Sixty five patients with CAD; defined as more than 50% stenosis in any segment by coronary angiography, and twenty five matched controls, were enrolled in this study. The study was carried out in Cardiology Department Assuit University hospital between October 2009 and July 2010. Metabolic syndrome was defined according to International Diabetes Federation criteris. The blood samples including complete blood count, fasting blood glucose, liver function tests, creatinine, urea, adiponectin, high sensitive-C reactive protein [hs-CRP], insulin and lipids profile were obtained after overnight fasting. The homeostatic model assessment of insulin resistance [HOMA-IR] was calculated as HOMA-IR = fasting blood glucose [mmol/l] x fasting serum insulin [micro U/ml]/22.5. Patients with CAD had significantly lower plasma adiponectin concentrations than those without CAD [P<0.013] and higher hs-CRP [P<0.009] and HOMA-IR [P<0.03]. Metabolic syndrome was present in 41 patients [63%] among CAD group. Fasting adiponectin values for these patients tended to decrease significantly in comparison to patients without metabolic syndrome [P value= 0.037]. Negative correlations were found between adiponectin and body mass index [BMI] [r=-0.205, P<0.05], waist circumference [WC] [r= -0.306, P<0.003], triglycerides [r= -0.222, P < 0.036] and hs-CRP [r= -0.223, P< 0.035] whereas a positive correlation was found between adiponectin and HDL [r= 0.273, P<0.003]. Also, adiponectin was significantly lower in patients with multi-vessel disease compared to other [P<0.05] whereas hs-CRP and HOMA-IR were significantly higher in patients with multi-vessel disease with [P<0.01 and 0.03] respectively. Serum adiponectin concentration is inversely correlated with metabolic syndrome among patients with CAD. Lower adiponectin concentration, and higher HOMA-IR and hs-CRP are associated with Cad and metabolic syndrome, and may be useful for risk stratification of CAD patients. The measurement of plasma adiponectin, HOMA-IR and hs-CRP levels may be useful for prediction of severity of coronary artery disease