The Changes and Influential Factors of Adiponectin、Apelin and Visfatin in Coronary Heart Disease Patients Accompanied with Abnormal Glucose Metabolism
|School||Central South University|
|Keywords||Coronary heart disease Glucose metabolism Adiponectin Apelin Visfatin|
Background: Coronary heart disease (coronary heart disease, CHD) in atherosclerosis is the main characteristics of the disease, its trends increasingly grim, always ranks in recent years, the first residents of the cause of death in China. Numerous studies have shown that about 2/3 of coronary heart disease in patients with impaired glucose metabolism abnormalities. Recently, adipose tissue as an endocrine organ has drawn increasing attention the fat secreted cytokines involved in vascular endothelial function, oxidative stress, angiogenesis, and glucose and lipid metabolism process, coronary heart disease and abnormal glucose metabolism plays important role as a bridge. This study is to observe the plasma adiponectin level changes of Apelin and visfatin three adipocytokines in patients with coronary heart disease with abnormal glucose metabolism and related factors. Methods: From August 2009 to April 2010 in our hospital of Cardiology hospital patients with coronary heart disease (coronary angiography, the presence of at least one coronary artery stenosis of 50%) and 87 cases according to the WHO diabetes diagnostic criteria ( 1999), whether the patient merger glucose metabolism disorders fall into three groups: coronary heart disease with abnormal glucose tolerance group the (CHD IGT group) 28 cases; 28 cases of coronary heart disease with diabetes group the (CHD DM group); simple CHD group (CHD group n = 31). Select the same period 31 cases of examination center of our hospital healthy as the normal control group (NC). Routine testing of blood glucose, blood lipids, liver and kidney function, and hs-CRP and other biochemical markers, detected by ELISA in all subjects plasma adiponectin level of Apelin and visfatin Gensini score system evaluation of each coronary atherosclerosis in patients with degree of hardening lesions. Results: (1) CHD IGT group CHD DM group and CHD group, plasma adiponectin, Apelin and visfatin concentrations were lower than NC group (all P lt; 0.05). (2) in CHD DM group, adiponectin than CHD IGT and CHD group, and statistical difference between groups (all P lt; 0.05); Apelin levels ranged between CHD and NC group (all P lt; 0.05), but with CHD IGT group had no statistical difference; the visfatin level with CHD and CHD IGT group were not statistically different (P gt; 0.05). (3) The correlation analysis showed that adiponectin and HDL-C significantly positive correlation (r = 0.483, P lt; 0.01), and TG, PPG and hs-CRP were negatively related (r = -0.197, -0.378, -0.489 are P lt; 0.05). In patients with coronary heart disease, Apelin and visfatin 2h postprandial glucose (PPG) and hs-CRP was positively correlated (r = 0.483,0.320; r = 0.249,0.309, all P lt; 0.05). (4) bivariate correlation analysis visfatin with the Apelin significant positive correlation (r = 0.948, P lt; 0.01). (5) Apelin as dependent variables of many factors linear regression analysis showed that PPG and FBG for the Apelin independent related factors, and multiple linear regression equation: of Apelin to = 75.60 4.025XPPG-8.092XFBG (and F = 3.342, P lt; 0.05); visfatin is less than the linear regression analysis of the variables of many factors, UA and hs-CRP as an independent visfatin related factors, multiple linear regression equation: visfatin = 5.003-0.005XUA 0.111Xhs- CRP (F = 6.573, P lt; 0.05). Conclusions: (1) Compared with the normal control group, plasma adiponectin in patients with coronary heart disease, Apelin and visfatin were significantly reduced. (2) simple coronary heart disease, coronary heart disease with impaired glucose tolerance and coronary heart disease patients with diabetes mellitus plasma adiponectin levels were decreased, and the difference was significant, suggesting that coronary heart disease patients with plasma adiponectin levels were associated with the degree of abnormal glucose metabolism. Adiponectin and hs-CRP was negatively correlated positively correlated with HDL-C, also suggest that it can better reflect and severity of the assessment of patients with coronary heart disease and the body's inflammatory state. (3) of coronary heart disease in patients with diabetes plasma Apelin level higher than coronary heart disease combined abnormal glucose tolerance and coronary heart disease, but no significant difference; Apelin independent related factors in patients with coronary heart disease, FBG and PPG, suggesting that coronary heart disease plasma of patients with high Apelin levels and abnormal glucose metabolism, particularly related to the occurrence of diabetes. (4) the level of plasma visfatin in coronary heart disease and abnormal glucose metabolism among the three groups were not significantly different; visfatin independent related factors in patients with coronary heart disease UA and hs-CRP, suggesting that patients with coronary heart disease visfatin levels of inflammatory related and has nothing to do with abnormal glucose metabolism.