The Effects Of Acarbose On Serum Adiponectin And Leptin Levers In Patients With Coronary Heart Disease And Impaired Glucose Tolerance

Objective(1)To study the changes of serum adiponectin and leptin levers in the patients with Coronary heart disease (CHD) and impaired glucose tolerance (IGT), and analyze the correlations.(2)To observe the effects of a-glueosidase inhibitor (Acarbose) on serum adiponectin and leptin levers in CHD patients with IGT, and analyze the correlations.MethodsBy OGTT,46 CHD patients were grouped two groups:CHD with IGT(n=19), simple CHD(n=27); and 33 health volunteers were also grouped two groups:simple IGT(n=15), normal control(n=18). The enzyme linked immunosorbent assay(ELISA) were used to determine the fasting serum levers of adiponectin and leptin, the fasting blood glucose(FBG) and postprandial blood glucose(2hPBG), fasting insulin(Fins), blood-fat, hs-CRP were assayed at the same time, we also measured the body height, body weight, waist circumference, then accounted BMI and HOMA-IR. After 3 months' intervention of Acarbose, we assayed all these indexes of simple IGT and normal control again.Results(1) The serum levers of adiponectin in CHD with IGT and simple CHD were significantly increased compared with controls (P＜0.01), and the levers in CHD with IGT were significantly lower than in simple IGT (P＜0.01). The serum levers of leptin in simple IGT were higher than in controls (P<0.05). The serum levers of adiponectin and leptin were not correlated with each other. The serum levers of adiponectin were negatively correlated with HOMA-IR (r=—0.464, P<0.01), and were positively correlated with HDL-c(r=0.171, P＜0.05), SBP(r=0.491,P＜0.01) and sex (r=0.354, P＜0.01). The serum levers of leptin were correlated with sex(r=0.435,P<0.01), BMI(r=0.391,P<0.01) and waist circumference,(r=0.289,P<0.05). (2) After intervention by Acarbose, the changes of serum adiponectin and leptin levers had statistics significance both in two groups (P＜0.01). The serum levers of adiponectin were increased, and the changes in CHD with IGT were larger than in simple IGT (P＜0.01). The serum levers of leptin were lower than before (P＜0.05), and the changes in simple IGT were larger than in CHD with IGT (P＜0.05). BMI,2hPBG, TC, TG, LDL-C, HOMA-IR of these two groups were also decreased. The serum levers of adiponectin and leptin were also not correlated with each other. The serum levers of adiponectin were positively correlated with HDL-C (r=0.626, P＜0.01) and were negatively correlated with HOMA-IR, Fins, hs-CRP (r=-0.633--0.416, P<0.05). The serum levers of leptin were not correlated with any indexes, female's were also higher than male's. The increase of adiponectin were negatively correlated with the changes of TG (r= -0.376, P<0.05); while the decrease of leptin were significantly correlated with sex(r=0.565,P<0.01), in another word, females had larger decrease of leptin than males.Conclusion(1) The serum levers of adiponectin were decreased in patients with CHD, and the levers became lower when the patients with IGT together. The serum levers of adiponectin were positively correlated with HOMA-IR, HDL-C, SBP, sex, and were higher in female than in male. The serum levers of leptin were increased in patients with IGT. There was no correlation between the serum levers of adiponectin and leptin. The serum levers of leptin were positively correlated only with sex, and were significantly higher in female than in male.(2) After the use of Acarbose, BMI,2hPBG, TC, TG, LDL-C, HOMA-IR were lower than the baselines. The serum levers of adiponectin were significantly higher, and the changes were correlated with the changes of TG; the serum levers of leptin were lower, and the changes were higher in women than men.(3) Acarbose may play a significant role in the cardiovascular protection to patients with CHD and IGT by affecting the serum levers of adiponectin and Leptin, which may improve obesity, postprandial hyperglycemia, insulin resistance and blood lipid disorders.