von Eynatten Maximilian, Humpert Per M, Bluemm Annabelle, Lepper Philipp M, Hamann Andreas, Allolio Bruno, Nawroth Peter P, Bierhaus Angelika, Dugi Klaus A
Department of Nephrology, Technical University Munich, Ismaningerstr. 22, 81675 Munich, Germany.
Atherosclerosis. 2008 Jul;199(1):123-8. doi: 10.1016/j.atherosclerosis.2007.10.002. Epub 2007 Nov 19.
Adiponectin has anti-atherogenic properties and low circulating adiponectin has been linked to coronary atherosclerosis. Yet, there is considerable evidence that the high-molecular weight (HMW) complex of adiponectin is the major active form of this adipokine. We therefore investigated whether HMW adiponectin is associated with the extent of coronary artery disease (CAD) in men.
Associations among CAD, HMW adiponectin and the HMW/total-adiponectin ratio were assessed in 240 male patients undergoing elective coronary angiography. Total adiponectin and HMW adiponectin was measured by enzyme-linked immunosorbent assay and serum levels were correlated with defined coronary scores and established cardiovascular risk factors.
We found significant inverse correlations between angiographic scores and HMW adiponectin [Extent Score (ES): r=-0.39; Gensini Score (GS): r=-0.35; and Severity Score (SS): r=-0.40, all P<0.001], and the HMW/total-adiponectin ratio (ES: r=-0.49; GS: r=-0.46; SS: r=-0.46; all P<0.001). Multivariable regression analyses revealed that HMW adiponectin and the HMW/total-adiponectin ratio were significantly associated with the extent of CAD (both P<0.001). ROC analyses demonstrated that the predictive value of HMW adiponectin and the HMW/total-adiponectin ratio for the extent of coronary atherosclerosis significantly exceeded that of total adiponectin (P<0.001, P=0.010, respectively).
HMW adiponectin and the HMW/total-adiponectin ratio inversely correlate with the extent of CAD. HMW adiponectin in particular seems to be a better marker for CAD extent than total adiponectin.
脂联素具有抗动脉粥样硬化特性，循环中脂联素水平低与冠状动脉粥样硬化有关。然而，有大量证据表明，脂联素的高分子量（HMW）复合物是这种脂肪因子的主要活性形式。因此，我们研究了HMW脂联素是否与男性冠状动脉疾病（CAD）的严重程度相关。
对240例接受选择性冠状动脉造影的男性患者评估CAD、HMW脂联素及HMW/总脂联素比值之间的关联。采用酶联免疫吸附测定法测量总脂联素和HMW脂联素，并将血清水平与确定的冠状动脉评分及既定的心血管危险因素相关联。
我们发现血管造影评分与HMW脂联素之间存在显著负相关[范围评分（ES）：r = -0.39；詹西尼评分（GS）：r = -0.35；严重程度评分（SS）：r = -0.40，均P < 0.001]，以及HMW/总脂联素比值（ES：r = -0.49；GS：r = -0.46；SS：r = -0.46；均P < 0.001）。多变量回归分析显示，HMW脂联素和HMW/总脂联素比值与CAD严重程度显著相关（均P < 0.001）。ROC分析表明，HMW脂联素和HMW/总脂联素比值对冠状动脉粥样硬化程度的预测价值显著超过总脂联素（分别为P < 0.001，P = 0.010）。
HMW脂联素和HMW/总脂联素比值与CAD严重程度呈负相关。特别是HMW脂联素似乎比总脂联素更能作为CAD严重程度的良好标志物。
