Correlative Study Of Serum Adiponectin And Inflammatory Mediators In Coronary Heart Disease Accompanied With Chronic Heart Failure

Background Adiponectin, which is a collagen-like plasma protein produced by adipose tissue, has anti-atherogenic and anti-inflammatory effects and improves insulin sensitivity and endothelium functional disorder.Many study have found it declined obviously in obesity,type 2 diabetes, atherosclerosis diseases in contrast with health adult.Our study aimed to observe the serum levels of patients with coronary heart disease(CHD) accompanied with chronic heart failur(eCHF)and patients with CHD accompanied without CHF,to investigate relationships between the serum levels of adiponectin and NTproBNP and the role of serum adiponectin and inflammatory mediators in patients with CHD accompanied with CHF.Methods The study group were comprised by 25 inpatients with CHD accompanied without CHF and 100 inpatients with CHD accompanied with CHF who were consective and divided into 3 subgroups according to the New York Heart Association function class,such as NYHAI-II class,NYHAⅢclass,NYHAIV class. 25 control subjects came from health examination whose age and sexy were similar to the patients class. Serum levels of fasting adiponectin,NTproBNP, hsCRP and other biochemical indicators were measured and compared among the groups. After the prompt improvement in cardiac function in the CHD with heavy heart failure ,we contrast the change of APN and NTproBNP.Results 1. Serum adiponectin in no CHF group(4.79±1.61μg/ml) is lower than the control group(6.98±1.62μg/ml),but serum adiponectin in CHF group(14.22±5.34μg/ml)is higher than the control group(p<0.001); 2. Serum adiponectin levels were significantly increased according to the severity of NYHA function class in CHF group(P<0.01);3. In partial correlation analyses adjusted for sexy,age, body mass index and et al, adiponectin by log was postive associated with NT-proBNP by log and hsCRP, adiponectin was negative associated with and LVEF,TC and TG in CHD group,and was no associated with HOMA-IR;Multiple linear regression showed that HDL-cholesterol (HDL-C),TG and TC were independently correlated with the concentration of adiponectin level in patients with CHD;4. After the prompt improvement in cardiac function , levels of serum adiponectin and NT-proBNP was rapidly reduced.Conclusion We find serum adiponectin levels in no CHF group were significantly decreased in contrast with control group ,but serum adiponectin levels in CHF group were increased higher than other two groups,and according to the severity of CHF the level adiponectin were increased obviously. After the prompt improvement in cardiac function,APN and NTproBNP were significantly reduced,Moreover, the level of adiponectin were positively correlated with the serum levels of NTproBNP and hsCRP.These results indicate that augmented release of adiponectin is involved in the pathogenesis of CHD and CHF , further study is needed to elucidate its exact role,the change of the serum adiponectin is possibly valuable for predicting incidence and prognosis of CHF in CHD and evaluating the therapeutic efficacy.