Hasan-Ali Hosam, Abd El-Mottaleb Nashwa A, Hamed Hosny B, Abd-Elsayed Alaa
Department of Cardiovascular Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt.
Coron Artery Dis. 2011 Jun;22(4):264-9. doi: 10.1097/MCA.0b013e3283452431.
The association of adipocyte-derived proteins, adiponectin and leptin, with the degree of coronary atherosclerosis has not been not been well elucidated. This study aimed to determine the relationship between serum adiponectin and leptin with the presence and degree of coronary atherosclerosis.
Seventy patients and 20 matched controls were recruited. Angiographic evaluation of coronary atherosclerosis was carried out by assessing three atherosclerotic indices, severity (transverse disease), extent (longitudinal disease), and pattern (lesion complexity).
The independent predictors of atherosclerosis severity were larger waist/hip ratio, followed by higher low-density lipoprotein-cholesterol, low serum adiponectin level, older age, higher leptin level, current unstable angina, and finally previous myocardial infarction (MI). This model is a good one as indicated by the model-adjusted r (50%). For extent index, lower serum adiponectin level was by far the most important independent predictor, followed by higher low-density lipoprotein-cholesterol, older age, and previous MI, whereas higher serum leptin level was only a univariate predictor. The model-adjusted r was 65%. For pattern index, the independent predictors were previous MI, lower serum adiponectin level, larger waist/hip ratio, higher serum leptin level, older age, and higher fasting blood glucose level. The model-adjusted r was 62%.
Both serum adiponectin and leptin might play an important pathogenic role not only in the occurrence but also in the severity, extent, and lesion complexity in coronary artery disease patients.
脂肪细胞衍生蛋白脂联素和瘦素与冠状动脉粥样硬化程度之间的关联尚未得到充分阐明。本研究旨在确定血清脂联素和瘦素与冠状动脉粥样硬化的存在及程度之间的关系。
招募了70例患者和20例匹配的对照。通过评估三个动脉粥样硬化指标，即严重程度（横向病变）、范围（纵向病变）和模式（病变复杂性），对冠状动脉粥样硬化进行血管造影评估。
动脉粥样硬化严重程度的独立预测因素依次为较大的腰臀比、较高的低密度脂蛋白胆固醇、较低的血清脂联素水平、较高的年龄、较高的瘦素水平、当前不稳定型心绞痛，最后是既往心肌梗死（MI）。如模型调整r（50%）所示，该模型良好。对于范围指数，较低的血清脂联素水平是迄今为止最重要的独立预测因素，其次是较高的低密度脂蛋白胆固醇、较高的年龄和既往心肌梗死，而较高的血清瘦素水平只是一个单变量预测因素。模型调整r为65%。对于模式指数，独立预测因素为既往心肌梗死、较低的血清脂联素水平、较大的腰臀比、较高的血清瘦素水平、较高的年龄和较高的空腹血糖水平。模型调整r为62%。
血清脂联素和瘦素不仅可能在冠心病患者的发病过程中起重要的致病作用，而且在其严重程度、范围和病变复杂性方面也起重要作用。
