| Objective: Adiponectin, also called GBP-28, apM1, AdipoQ, and Acrp30, an lately discovered adipose tissue-specific protein that has structural homology to collagen VIII and X and complement factor C1q, circulates at high levels in human plasma. It is one of the adipocyte-expressed proteins that contribute to the homeostatic control of glucose, lipid, energy metabolism, and it has anti-inflammatory and antiatherogenic effects.Now it has been proved that adiponectin is significantly lower in the patients with type-2 diabetes,cardiovascular disease and obesity .Cerebral ischemic stroke(CIS) is a kind of familiar disease endangering mankinds'health, it is the second leading cause of mortality worldwide, artherosclerosis is the basic cause of CIS.Although many findings indicate that adiponectin plays a crucial role in the development of atherosclerosis, to the best of our knowledge, there have been no studies of the association between plasma adiponectin and cerebral infarction(CI), whether adiponectin is involved in CI is the point of our study.Hypertension is a common disease that increases the risk for cerebrovascular disease, and it is also a component of the metabolic syndrome.Even though an association between essential hypertension and serum adiponectin concentration has been reported ,the obtained results were not identical.Furthermore, in these studies, the association between plasma adiponectin and hypertension was evaluated without adjusting for confounding factors. in my syudy, we will have Thorough research on adiponectin levels of essential hypertension, on this foundation ,we have strict medical history sieving and set dividing, then to explore the changing of adiponectin in the patients of cerebral infarction. Meanwhile,the Correlation between adiponectin and other known atherosclerotic risk factors,plasma biochemical parameters,Severity of the disease will also be explored.To improve whether hypoadiponectinemia is present in patients with ischemic cerebrovascular disease and essential hypertension, it may be a possible target for antihypertensive and antiatherogenic treatment.Methods: 1 Subjects From December 2005 to May 2006, 35 hypertensive subjects were selected in our clinics, Hypertension was defined as a systolic blood pressure of≥140 mm Hg and/or a diastolic blood pressure of≥90 mm Hg on repeated measurements, or receiving antihypertensive treatment. 70 CI subjects within 3 days was defined as patients with an acute or sudden focal neurological defect lasting for >24 hours and positive brain image lesions by computed tomography or magnetic resonance imaging, Patients with diabetes,cardiovascular disease and obesity(BMI:weight/height2≥25), acute or chronic infection,tumor,renal failure and other chronic disease,Also excluded were patients with CI caused by less common causes such as drugs, metabolic disease, infection, vasculopathy, moyamoya disease, or venous thrombosi- s,meanwhile,we chose 20 healthy person as the control subjects.2 scoring and grouping The patients with CI were required by CT . the severity of neurological defect were examined with National Institutes of Health Stroke Scale (NIHSS).The volume of infarction were caculated by Pullicino ,divide into mild infarction ,volume<5cm3; moderate infarction,volume5~10 cm3, severe infarction,volume >10 cm3.(BF%):male=1.2×BMI+ 0.23×age-16.2,female=1.2×BMI +0.23×age-5.43 biochemical Examination All blood samples were drawn after an overnight fast. Plasma samples were kept at -20°C for subsequent assay。The concentration of plasma adiponectin was determined by enzyme-linked immunosorbent assay kit(Assaypro company), TNF-αwas measured by radio-immunoassay method ,c-reactive protein was measured by turbidmetry immunoassay. Blood pressure ,Plasma trigly- cerides, total cholesterol, LDL cholesterol, HDL cholesterol, glucose and other biochemical parameters were measured, too.Results: 1. Plasma adiponectin concentration was significantly lower in hypertensive subjects than in normotensive subjects [ (5.59±2.68) vs (11.9±1.8 mg/L ) , P<0.05],After adjustment for confounding factors (age, BMI, and T-chol etc), adiponectin concentration was significantly lower in HT,Multiple regression analysis revealed that blood glucose and Systolic blood pressure independently affected the Plasma adiponectin.2 So,the CI subjects with hypertension were excluded from the CI group, The mean plasma level of adiponectin was significantly lower in patients with CI than control subjects[(3.0±1.4mg/L ),(3.5±1.0mg/L)vs(11.9±1.8mg/L),P<0.01], The plasma adiponectin levels remained significantly lower after adjustment for age, sex, BMI, and smoking status,etc. The mean plasma adiponectin levels in patients with small artery infarctions were not different from those with large artery infarctions. our study also showed that plasma adiponectin level was significantly associated with all components of metabolic syndrome, which are well-known risk factors for development of atherosclerosis such as BP, plasma glucose, serum triglyceride, HDL cholesterol,we also found that patients with CI have higher levels of CRP and TNF-α,they are negtively correlated with adiponectin and were significantly associated with the severity of the disease.Couclusions: the present study shows that plasma adiponectin concentration is low in patients with hypertension and CI. hypoadiponectinemia may be the risk factor for hypertension and CI, This evidence suggests that adiponectin plays a crucial role in the inflammatory process and the development of atherosclerosis. Patients with hypoadi- ponectinemia may, therefore, have less antiinflammatory ability and be more vulnerable to the development of ischemic vascular disease. and it finds a possible close relationship between adiponectin- metabolic syndrome-inflammation and the development of atherosclerosis, there could be a possible target for antihypertensive and antiatherogenic treatment in future.
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