The Changes And Influential Factors Of Adiponectin,Apelin And Visfatin In Coronary Heart Disease Patients Accompanied With Abnormal Glucose Metabolism

Background:Coronary heart disease(CHD) was characterized by atherosclerosis, is spreading widely in recent years. Adipose tissue was raising great concern for us as an endocrine organ, since adipocytokines which were secreted by adipose tissue involved in the processes of endothelial function, oxidative stress, revascularization, metabolism of glucose and lipid and so on, it may be a link between CHD and abnormal glucose metabolism. So we investigate the level and influence factors of plasma Adiponectin,Apelin and Visfatin in CHD patients accompanied with abnormal glucose metabolism.Methods:87 CHD patients diagnosed by coronary artery angiography (CAG) from Xiangya hospital were enrolled in this study. Imparied glucose tolerence and diabetic mellitus were both diagnosed in 28 out of 87 CHD patients (CHD+IGT and CHD+DM group), the rest 31 patients were enrolled in CHD group. Meanwhile,31 people were collected among the healthy examined people (NC group). The concentrations of fasting plasma glucose (FPG), post-prandial glucose(PPG), insulin, total cholesterol (TC), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), blood urea nitrogen (BUN), creatinine (CR), uric acid (UA) and hs-CRP were all determined. Plasma concentrations of Adiponectin,Apelin and Visfatin were analyzed by ELISA and the extent of coronary artery atherosclerosis was evaluated by Gensini score system.Results:(1)Compared with group NC, the levels of Adiponectin,Apelin and Visfatin in the groups of CHD+IGT, CHD+DM and CHD decreased significantly (all P<0.05). (2)The level of Adiponectin was lower in group CHD+DM than in group CHD+IGT and CHD(all P<0.05), the level of Apelin was lower in group CHD than in group CHD+DM and NC(all P<0.05), but there was no obvious statistical significance of Visfatin between in group CHD+DM and the other two CHD groups(P>0.05). (3)Adiponectin was positively correlated with HDL-C (P<0.01) and negatively correlated with TG, PPG and hs-CRP (all P<0.05). In patients with coronary heart disease, Apelin and Visfatin were positively correlated with PPG and hs-CRP(all P<0.05). (4) There had strong positive correlation between Apelin and Visfatin (P<0.05). (5) The results showed that FBG and PPG were related factors for Apelin in CHD patients by Multivariate linear regression analysis; UA and hs-CRP were for Visfatin by the same method.Conclusions:(1) Compared with the normal control group, Plasma Adiponectin,Apelin and Visfatin were significantly decreased in CHD patients. (2) The level of Adiponectin was lower in group CHD+DM than in group CHD+IGT and CHD. Adiponectin was correlated with HDL-C,hs-CRP and PPG, so it may evaluate and reflect the disease severity and status of inflammation in CHD patients,and maybe correlate with the degree of abnormal glucose metabolism. (3) The level of Apelin was lower in group CHD than in group CHD+DM and NC. In CHD patients, FBG and PPG were independent related factors for Apelin. The above pointed out that in CHD patients Apelin was correlated with abnormal glucose metabolism, especially with DM. (4)There was no obvious statistical significance of Visfatin between in group CHD accompanied with abnormal glucose metabolism and the CHD group. In coronary heart disease, UA and hs-CRP were independent related factors for Visfatin.The above pointed out that in CHD patientsVisfatin was correlated with inflammation status, but not glucose metabolism.