脂联素比胰岛素抵抗指数、体重指数、免疫反应性胰岛素或甘油三酯更能预测冠状动脉内皮功能。

Adiponectin is a better predictor of endothelial function of the coronary artery than HOMA-R, body mass index, immunoreactive insulin, or triglycerides.

作者信息

Okui Hideki, Hamasaki Shuichi, Ishida Sanemasa, Kataoka Tetsuro, Orihara Koji, Fukudome Tsuyoshi, Ogawa Masakazu, Oketani Naoya, Saihara Keishi, Shinsato Takuro, Shirasawa Takahiro, Mizoguchi Etsuko, Kubozono Takuro, Ichiki Hitoshi, Ninomiya Yuichi, Matsushita Takehiko, Nakasaki Mitsuhiro, Tei Chuwa

机构信息

Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan.

出版信息

Int J Cardiol. 2008 May 7;126(1):53-61. doi: 10.1016/j.ijcard.2007.03.116. Epub 2007 May 2.

DOI:10.1016/j.ijcard.2007.03.116

PMID:17477992

Abstract

BACKGROUND

Previous studies have demonstrated that decreased levels of circulating adiponectin correlate with endothelial dysfunction in peripheral arteries. However, the relationship between adiponectin levels and endothelial function in coronary arteries remains unclear. The goal of the present study was to determine whether circulating adiponectin concentrations are a useful predictor of coronary endothelial function.

METHODS

Thirty-six consecutive non-diabetic patients with normal or mildly diseased coronary arteries were enrolled in this study. Coronary endothelial function was evaluated by coronary vascular response to acetylcholine (Ach). The relationship between coronary vasoreactivity and adiponectin or other biochemical or anthropometric parameters was investigated. The predictive value of adiponectin level for assessment of coronary endothelial dysfunction was assessed at the best cut-off point.

RESULTS

In a simple regression analysis, log-transformed adiponectin concentrations positively correlated with the percent change in coronary blood flow (CBF) and coronary artery diameter (CAD) induced by Ach (r=0.62, p<0.0001; r=0.63, p<0.0001, respectively). Insulin resistance index (HOMA-R), body mass index, immunoreactive insulin, and triglycerides concentrations also significantly correlated with the percent change in CBF and CAD. However, in a multiple regression analysis, log-transformed adiponectin concentration was the only independent predictor of the percent change in CBF and CAD (p<0.0001; p<0.0001, respectively). Furthermore, patients with adiponectin concentrations <6.3 mg/L demonstrated coronary endothelial dysfunction with high specificity both in terms of CBF and CAD response (85%; 88%, respectively).

CONCLUSIONS

Adiponectin is a better predictor of coronary endothelial function than other factors such as HOMA-R, body mass index, immunoreactive insulin, and triglycerides.

摘要

背景

既往研究表明，循环脂联素水平降低与外周动脉内皮功能障碍相关。然而，脂联素水平与冠状动脉内皮功能之间的关系仍不明确。本研究的目的是确定循环脂联素浓度是否是冠状动脉内皮功能的有用预测指标。

方法

本研究纳入了36例冠状动脉正常或轻度病变的非糖尿病患者。通过冠状动脉对乙酰胆碱（Ach）的血管反应评估冠状动脉内皮功能。研究了冠状动脉血管反应性与脂联素或其他生化及人体测量参数之间的关系。在最佳切点评估脂联素水平对冠状动脉内皮功能障碍评估的预测价值。

结果

在简单回归分析中，经对数转换的脂联素浓度与Ach诱导的冠状动脉血流量（CBF）和冠状动脉直径（CAD）的变化百分比呈正相关（r = 0.62，p < 0.0001；r = 0.63，p < 0.0001）。胰岛素抵抗指数（HOMA-R）、体重指数、免疫反应性胰岛素和甘油三酯浓度也与CBF和CAD的变化百分比显著相关。然而，在多元回归分析中，经对数转换的脂联素浓度是CBF和CAD变化百分比的唯一独立预测指标（分别为p < 0.0001；p < 0.0001）。此外，脂联素浓度<6.3 mg/L的患者在CBF和CAD反应方面均表现出高特异性的冠状动脉内皮功能障碍（分别为85%；88%）。