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冠心病男性患者中高分子量形式脂联素的临床意义

Clinical significance of high-molecular weight form of adiponectin in male patients with coronary artery disease.

作者信息

Komura Noriyuki, Kihara Shinji, Sonoda Mina, Kumada Masahiro, Fujita Koichi, Hiuge Aki, Okada Takuya, Nakagawa Yasuhiko, Tamba Sachiko, Kuroda Yohei, Hayashi Noriyuki, Sumitsuji Satoru, Kawamoto Toshiharu, Matsumoto Satoru, Ouchi Noriyuki, Arita Yukio, Okamoto Yoshihisa, Shimomura Iichiro, Funahashi Tohru, Matsuzawa Yuji

机构信息

Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita, Japan.

出版信息

Circ J. 2008 Jan;72(1):23-8. doi: 10.1253/circj.72.23.

Abstract

BACKGROUND

It has been reported previously that the measurement of plasma total adiponectin level is clinically useful to estimate the risk of coronary artery disease (CAD). Here, the relevance of high molecular weight (HMW) adiponectin with risk factors for atherosclerosis is investigated

METHODS AND RESULTS

A total of 186 consecutive male CAD patients participated in the study and were categorized into quartiles based on their total adiponectin level. The interquartile cut-off points were 4.0, 5.5 and 7.0 microg/ml. The HMW adiponectin levels were significantly lower in the quartile of lower total adiponectin levels both in non-diabetic and diabetic patients. In contrast, low molecular weight adiponectin levels (which were calculated as the Total - HMW) were constant. In univariate analysis, total adiponectin correlated negatively with body mass index and hemoglobin (Hb) A1c, and HMW adiponectin correlated negatively with HbA1c in non-diabetic patients. On the other hand, total and HMW adiponectin correlated positively with high-density lipoprotein-cholesterol (HDL-C) in diabetic patients. Multiple regression analysis revealed that HMW adiponectin correlated negatively with HbA1c in non-diabetic patients, and total and HMW adiponectin correlated positively with HDL-C in diabetic patients.

CONCLUSIONS

Change in the HMW isoform reflects a change in total adiponectin level. Measurement of total and HMW adiponectin were equally useful in assessing metabolic risk in CAD patients.

摘要

背景

此前有报道称,检测血浆总脂联素水平对评估冠状动脉疾病(CAD)风险具有临床意义。在此,研究了高分子量(HMW)脂联素与动脉粥样硬化危险因素之间的相关性。

方法与结果

共有186例连续入选的男性CAD患者参与本研究,并根据其总脂联素水平分为四分位数。四分位数间距的截断点分别为4.0、5.5和7.0微克/毫升。在非糖尿病和糖尿病患者中,总脂联素水平较低的四分位数组中,HMW脂联素水平均显著降低。相比之下,低分子量脂联素水平(通过总脂联素减去HMW脂联素计算得出)保持不变。单因素分析显示,在非糖尿病患者中,总脂联素与体重指数和糖化血红蛋白(Hb)A1c呈负相关,HMW脂联素与HbA1c呈负相关。另一方面,在糖尿病患者中,总脂联素和HMW脂联素与高密度脂蛋白胆固醇(HDL-C)呈正相关。多元回归分析显示,在非糖尿病患者中,HMW脂联素与HbA1c呈负相关,在糖尿病患者中,总脂联素和HMW脂联素与HDL-C呈正相关。

结论

HMW异构体的变化反映了总脂联素水平的变化。检测总脂联素和HMW脂联素在评估CAD患者代谢风险方面同样有用。

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