Liang Kae-Woei, Lee Wen-Jane, Lee Wen-Lieng, Ting Chih-Tai, Sheu Wayne H-H
Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan.
Clin Chim Acta. 2009 Jul;405(1-2):114-8. doi: 10.1016/j.cca.2009.04.018. Epub 2009 May 3.
Adiponectin is thought to protect against atherosclerosis and its expression is decreased in metabolic syndrome and diabetes mellitus. Adiponectin has a high-molecular-weight (HMW) multimer structure in the blood. We determined whether circulating HMW adiponectin, total adiponectin, or their ratio predicts baseline angiographic coronary artery disease (CAD) severity and restenosis after percutaneous coronary intervention (PCI).
Patients with stable angina pectoris who underwent PCI for a de novo lesion and had angiographic follow-up at our hospital were retrospectively enrolled. The study patients were grouped as moderate (N=68) or severe (N=63) coronary atherosclerosis by the baseline median Gensini severity score (moderate<22, severe> or =22).
Univariate analysis showed that subjects in the severe CAD group had a lower HMW/total adiponectin ratio (0.32+/-0.19 vs. 0.37+/-0.16, p=0.024) while the absolute value of HMW adiponectin (2.17+/-2.05 vs. 2.27+/-2.07 microg/ml, p=0.389) and total adiponectin (5.97+/-3.12 vs. 5.76+/-2.91 microg/ml, p=0.807) were similar between the severe and moderate CAD groups. In a multivariate binary logistic regression model, a higher serum HMW/total adiponectin ratio (odds ratio 0.058, p=0.018) was negatively, while hypercholesterolemia (OR 2.475, p=0.029) was positively associated with coronary atherosclerosis disease severity. In terms of restenosis after PCI (mean follow-up at 12+/-13 months), HMW adiponectin, total adiponectin and their ratio were similar between restenotic (N=91) and non-restenotic groups (N=40).
A decreased ratio of circulating HMW adiponectin to total adiponectin is associated with angiographic disease severity but not restenosis in CAD patients undergoing PCI.
脂联素被认为具有抗动脉粥样硬化作用,其在代谢综合征和糖尿病患者中的表达降低。脂联素在血液中具有高分子量(HMW)多聚体结构。我们研究了循环中的HMW脂联素、总脂联素或其比值是否能预测经皮冠状动脉介入治疗(PCI)后基线血管造影所示的冠状动脉疾病(CAD)严重程度及再狭窄情况。
回顾性纳入我院因新发病变接受PCI且有血管造影随访的稳定型心绞痛患者。根据基线Gensini严重程度评分中位数(中度<22,重度≥22)将研究患者分为中度(N = 68)或重度(N = 63)冠状动脉粥样硬化组。
单因素分析显示,重度CAD组患者的HMW/总脂联素比值较低(0.32±0.19 vs. 0.37±0.16,p = 0.024),而重度和中度CAD组之间HMW脂联素的绝对值(2.17±2.05 vs. 2.27±2.07μg/ml,p = 0.389)和总脂联素(5.97±3.12 vs. 5.76±2.91μg/ml,p = 0.807)相似。在多因素二元逻辑回归模型中,较高的血清HMW/总脂联素比值(比值比0.058,p = 0.018)与冠状动脉粥样硬化疾病严重程度呈负相关,而高胆固醇血症(OR 2.475,p = 0.029)与冠状动脉粥样硬化疾病严重程度呈正相关。就PCI后的再狭窄情况(平均随访12±13个月)而言,再狭窄组(N = 91)和无再狭窄组(N = 40)之间的HMW脂联素、总脂联素及其比值相似。
循环中HMW脂联素与总脂联素的比值降低与接受PCI的CAD患者的血管造影疾病严重程度相关,但与再狭窄无关。