Relationship among Gensini score and levels of glucose and adiponectin in patients with stable angina pectoris

Year 2012, , 229 - 234, 01.06.2012

Ferhat Özyurtlu Özgül Yıldız Erkan Ayhan Turgay Işık Halit Acet Zihni Bilik Uğur Kemal Tezcan

https://doi.org/10.5799/ahinjs.01.2012.02.0149

Abstract

Objectives: Adiponectin is an adipocyte-secreted protein that modulates insulin sensitivity and whose low circulating concentration is associated with insulin resistance. We evaluated the association between serum adiponectin and blood glucose levels with coronary artery disease severity on the angiogram in patients with stable angina pectoris. Materials and methods: The study included 160 patients (82 males) with stable angina pectoris. The patients were divided into three groups according to the blood glucose levels on admission; thus, 24 had normal glucose group, 53 had impaired glucose tolerance group, and 53 had diabetes mellitus (DM) group. The severity of coronary lesions was assessed using the Gensini score. Serum adiponectin levels were measured in the all group. Results: The hypertension, hyperlipidemia, obesity, and insulin resistance were significantly higher in the DM group. Patients with DM significantly lower serum levels of adiponectin (13.55±7.16, p=0.002). The mean Gensini score was 40.84± 37.25 in the DM group (p=0.006). Conclusion: Serum adiponectin levels may be a clue for severity coronary artery disease in patients with stable angina pectoris. J Clin Exp Invest 2012; 3(2): 229-234

Keywords

Adiponectin, diabetes mellitus, coronary angiography, insulin resistance, stable angina pectoris

Stabil anjina pektorisli hastalarda Gensini skoru, adiponektin ve glikoz düzeyleri arasındaki ilişki

Abstract

Amaç: Adiponektin, insülin duyarlılığını düzenleyen ve adipositden sekrete edilen bir proteindir ve dolaşımdaki seviyesinin azalması insülin direnci ile ilişkilidir. Biz, stabil anjina pektorisli hastalarda serum adiponektin ve kan glikoz seviyeleri ile koroner arter hastalığı şiddeti arasındaki ilişkiyi değerlendirmeyi amaçladık. Gereç ve yöntem: Bu çalışmaya stabil anjina pektorisli 160 hasta (82 erkek) dahil edildi. Hastalar başvuru esnasındaki kan glikoz seviyerine göre 3 gruba ayrıldı; 24 hasta normal kan glikoz grubu,53 hasta bozulmuş glikoz tolerans grubu ve 53 hasta diabetes mellitus (DM) grubu. Koroner lezyonların şiddeti Gensini skoru kullanarak değerlendirildi. Tüm gruplarda serum adiponektin seviyeleri de ölçüldü. Bulgular: Hipertansiyon, hiperlipidemi, obesite ve insülin direnci DM grupta anlamlı olarak daha yüksekdi. DM'li hastalarda serum adiponektin seviyeleri anlamlı olarak daha düşük saptandı (13.55±7.16, p=0.002). Ortalama Gensini skoru DM grupta 40.84 ±37.25 olarak saptandı (p=0.006). Sonuç: Stabil anjina pektorisi olan hastalarda serum adiponektin düzeyleri koroner arter hastalığı yaygınlığı için bir ipucu olabilir.

Keywords

Adiponektin, diabetes mellitus, koroner anjiografi, insulin direnci, stabil anjina pektoris

References

• John M. Canty Jr. Coronary blood flow and myocar- dial ischemia. In: Bonow RO, Zipes DP, Libby P, Mann DL (eds.). Heart disease. A Textbook of Cardiovascu- lar Medicine. Philadelphia, WB Saunders Company, 2011:1049-1074.
• Watkins SM, Rowe MW, Kolberg JA, Wagenknecht LE, Bergman RN. Biomarker models as Surrogates for the Disposition index in the Insulin Resistance Athero- sclerosis Study. Diabet Med 2012;13.Ulaşılabileceği adres: j.1464-5491.2012.03625.x/pdf
• Fullerton MD, Steinberg GR, Schertzer JD. Immuno- metabolism of AMPK in insulin resistance and athero- sclerosis. Mol Cell Endocrinol.2012;14.Ulaşılabileceği adres: http://www.sciencedirect.com/science/article/ pii/ S0303720712000810
• Dandona P, Aljada A. A rational approach to pathogen- esis and treatment of tppe 2 diabetes mellitus, insulin resistance, inflammation and atherosclerosis. Am J Cardiol 2002; 90(5A): 27-33.
• Ohnishi H, Saitoh S, Ura N, et al. Relationship between insulin resistance and accumulation of coronary risk factors. Diabetes, Obesity Metabolism 2002;4(6): 388-93.
• Arcaro G, Cretti A, Balzano S, et al. Insulin causes endothelial dysfunction in humans: sites and mecha- nisms. Circulation 2002; 105(5):576-82.
• Vehkavaara S, Makimattila S, Schlenzka A, et al. In- sulin therapy improves endothelial function in type 2 diabetes. Arterioscler Thromb Vasc Biol 2000; 20(2): 545-50.
• Han SH, Quon MJ, Kim JA, Koh KK. Adiponectin and cardiovascular disease: response to therapeutic inter- ventions. J Am Coll Cardiol 2007;49(5):531-8.
• Ouchi N, Kihara S, Arita Y, et al. Novel modula- tor for endothelial adhesion molecules: adipocyte- derived plasma protein adiponectin. Circulation 1999;100(25):2473-6.
• Salmenniemi U, Ruotsalainen E, Pihlajamaki J, et al. Multiple abnormalities in glucose and energy metabo- lism and coordinated changes in levels of adiponectin, cytokines, and adhesion molecules in subjects with metabolic syndrome. Circulation 2004;110(25):3842-8.
• American Diabetes Association. Diagnosis and clas- sification of diabetes mellitus. Diabetes Care 2012;35 (Suppl 1):S64-71.
• Radziuk J. Insulin sensitivity and its measurement:structural commonalities among the methods. J Clin Endocrinol Metab 2000; 85(12):4426- 33.
• Gensini GG. Coronary arteriography: role in myocar- dial revascularization. Postgrad Med 1978;63(1):121- 8.
• Quadros AS, Sarmento-Leite R, Bertoluci M, et al. An- giographic coronary artery disease is associated with progressively higher levels of fasting plasma glucose. Diabet Res Clin Pract 2007; 75(2): 207-13.
• Lamounier-Zepter V, Ehrhart-Bornstein M, Bornstein SR. Insulin resistance in hypertension and cardiovas- cular disease. Best Pract Res Clin Endocrinol Metabol 2006; 20(3): 355-67.
• Andreas F, Anthony J, Pussell P, et al. Inflamation in the prediabetic state is related to increased insülin re- sistance rather than decreased insülin secretion. Cir- culation 2003; 108(15):1822-30.
• Ouchi N, Walsh K.Adiponectin as an anti-inflammato- ry factor. Clin Chim Acta 2007;380(1-2): 24-30.
• Shimada K, Miyazaki T, Daida H. Adiponectin and ath- erosclerotic disease. Clin Chim Acta 2004; 344(1-2): 1-12.
• Pischon T, Girman CJ, Hotamışlıgil GS, Rifai N, Hu FB, Rimm EB. Plasma adiponectin levels and risk of myocardial infarction in men. JAMA 2004; 291(14): 1730-7.
• Shioji K, Moriwaki S, Takeuchi Y, Uegaito T, Mutsuo S, Matsuda M. Relationship of serum adiponectin level to adverse cardiovascular events in patients who undergo percutaneous coronaryintervention. Circ J 2007;71(5): 675-80.
• Selcuk MT, Selcuk H, Temizhan A, et al. Impact of plasma adiponectin levels to the presence and sever- ity of coronary artery disease in patients with metabol- ic syndrome. Coronary Artery Dis 2008; 19(2):79-84.
• Xia K, Guo L, Zhao Z, Md Sayed AS, Li F, Yang T. Plasma level of adiponectin in coronary heart dis- ease patients combined with abnormal glucose me- tabolism. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2012;37(2):179-84.
• Han SH, Quon MJ, Kim J, Koh KK. Adiponectin and cardiovascular disease: response to therapeutic inter- ventions. J Am Coll Cardiol 2007;49(5): 531-8
• Inoue T, Kotooka N, Morooka T, et al. High molecular weight adiponectin as a predictor of long-term clinical outcome in patients with coronary artery disease. Am J Cardiol 2007; 100(4): 569-74.