Xia Ke, Guo Lanyan, Zhao Zhenyu, Md Sayed Ali Sheikh, Li Fei, Yang Tianlun
Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2012 Feb;37(2):179-84. doi: 10.3969/j.issn.1672-7347.2012.02.012.
To examine the plasma adiponectin concentration in coronary heart disease (CHD) patients combined with abnormal glucose metabolism, and to explore the clinical significance of adiponectin.
Eighty-seven hospitalized CHD patients confirmed by coronary angiography from August 2009 to April 2010 at Xiangya Hospital were enrolled and divided into 3 groups according to their glucose metabolic state: 31 patients were selected as a simple CHD group, 28 were selected as a CHD combined with impaired glucose tolerance group (CHD+IGT group), and the other 28 as a CHD combined with diabetes mellitus group (CHD+DM group). The 31 healthy subjects who got health checkup at the same time were enrolled as a normal control group (NC group). Plasma adiponectin was measured by enzyme linked immunosorbent assay. The height, weight,waistline and blood pressure of all the subjects were checked, and the fasting blood glucose (FBG), insulin, lipids, high-sensitivity C-reactive protein (hs-CRP), free fatty acids (FFA), the liver function and the renal function were checked as well. The body mass index and the homeostasis model were assessed for insulin resistance.
Plasma adiponectin concentration is reduced in the CHD patients, and significantly reduced in CHD patients combined with abnormal glucose metabolism. Plasma adiponectin concentration decreases significantly with the severity of abnormal glucose metabolism. CHD and the abnormal glucose metabolism are important influence factors for plasma adiponectin. That plasma adiponectin level significantly decreases may be the superimposed results of CHD and abnormal glucose metabolism. Plasma adiponectin combined with HDL-C, hs-CRP and Gensini score may provide the reference in the judgement of the severity of CHD patients with abnormal glucose metabolism.
检测冠心病（CHD）合并糖代谢异常患者血浆脂联素浓度，探讨脂联素的临床意义。
选取2009年8月至2010年4月在湘雅医院住院、经冠状动脉造影确诊的87例CHD患者，根据糖代谢状态分为3组：选取31例患者作为单纯CHD组，28例作为CHD合并糖耐量减低组（CHD+IGT组），另28例作为CHD合并糖尿病组（CHD+DM组）。选取同期进行健康体检的31例健康受试者作为正常对照组（NC组）。采用酶联免疫吸附法测定血浆脂联素。检测所有受试者的身高、体重、腰围和血压，同时检测空腹血糖（FBG）、胰岛素、血脂、高敏C反应蛋白（hs-CRP）、游离脂肪酸（FFA）、肝功能和肾功能。评估体重指数和稳态模型评估胰岛素抵抗。
1）CHD组、CHD+IGT组和CHD+DM组血浆脂联素均低于NC组（P<0.05）；2）与CHD组比较，CHD+DM组血浆脂联素最低，其次为CHD+IGT组，3组间差异有统计学意义（P<0.05）；3）血浆脂联素水平与高密度脂蛋白胆固醇-C（HDL-C）呈正相关（r=0.483，P<0.01），与hs-CRP和Gensini评分呈负相关（r=-0.489，P<0.05；r=-0.252，P<0.05）。
CHD患者血浆脂联素浓度降低，CHD合并糖代谢异常患者血浆脂联素浓度显著降低。血浆脂联素浓度随糖代谢异常严重程度显著降低。CHD和糖代谢异常是血浆脂联素的重要影响因素。血浆脂联素水平显著降低可能是CHD和糖代谢异常叠加的结果。血浆脂联素联合HDL-C、hs-CRP和Gensini评分可为判断CHD合并糖代谢异常患者的病情严重程度提供参考。
