Serum Adiponectin and Leptin as Predictors of the Presence and Degree of Coronary Atherosclerosis

Nashwa Abd El-Mottaleb, Hosam Ali, Hosny Hamed, Alaa Abd-Elsayed
2009 Bulletin of Egyptian Society for Physiological Sciences  
Recently, the adipocyte derived proteins; adiponectin and leptin, have been found to be associated with obesity, type 2 diabetes, insulin resistance, hyperinsulinemia, dyslipidemia and the presence of coronary artery disease. However, the association of these proteins with the degree of coronary atherosclerosis has not been not been well elucidated. Objectives: To determine the relationship between serum adiponectin and leptin levels and the presence and degree of coronary atherosclerosis.
more » ... herosclerosis. Methods: Seventy patients performing diagnostic coronary angiography in our catheterization laboratory for the investigation of coronary artery disease (CAD) were recruited. The control group included (20 subjects) who were non-diabetics, non-hypertensives, with no history of previous acute coronary syndrome, having normal ECG, of matched age, sex, body mass index (BMI), and waist/hip ratio, performing coronary angiography for stable angina with inadequate exercise test results, and proved to have a completely normal coronary angiography. All cases and control were subjected to complete history and clinical examination including 12 lead ECG, measurement of BMI, and hip/waist ratio. Fasting blood glucose, full lipogram, serum adiponectin, and serum leptin were measured. Angiographic evaluation of coronary atherosclerosis was performed by assessing three atherosclerotic indices; severity (transverse disease), extent (longitudinal disease), and pattern (lesion complexity). Results: The independent predictors of the atherosclerosis lesion severity were larger waist/hip ratio (beta, 0.34), followed by higher LDL-cholesterol (beta, 0.32), low serum adiponectin level (beta, -0.23), older age (beta, 0.19), higher leptin level (beta, 0.17), current unstable angina (beta, 0.17), and finally previous myocardial infarction (MI) (beta, 0.14). This model is a good one as indicated from the model adjusted r 2 (50%). For the extent of atherosclerosis index lower serum adiponectin level was by far the most important independent predictor (beta, -0.45), followed by higher 0.23), older age and previous MI (beta, 0.21 for both), while higher serum leptin level was only a univariate predictor. The model adjusted r 2 was 65%. For the atherosclerosis pattern index, the independent predictors were previous MI (beta, 0.31), lower serum adiponectin level (beta, -0.29), larger waist/hip ratio (beta, 0.26), higher serum leptin level (beta, 0.24), older age (beta, 0.22), and higher fasting blood glucose level (beta, 20). The model adjusted r 2 was 62%. Conclusion: Both serum adiponectin and leptin Bull. Egypt. Soc. Physiol. Sci. 29 (2) 2009 Abd El-Mottaleb et al. 34 might play an important pathogenic role not only in the occurrence but also in the severity, extent and lesion complexity in CAD patients.
doi:10.21608/besps.2009.36351 fatcat:63v7fkixxnddxbuvcmlhexo54q