Relationship Between Serum Levels Of Adiponectin,ykl-40 And Coronary Heart Disease And Coronary Artery Lesions

Objective To investigate relationship between serum levels of adiponectin and YKL-40 and different clinical types of coronary heart disease and stability of atherosclerotic plaque and severity of coronary artery lesions and risk factors of coronary heart disease such as obesity, blood glucose level.Methods 94 patients underwent coronary angiography were included. They were divided into four groups according to clinical history:normal control group,stable angina pectoris (SAP)group,unstable angina pectoris (UAP)group and acute myocardial infarction(AMI) group. They were divided into four groups according to the number of coronary artery stenosis: normal control group,single vessel disease group,double vessels disease group and three vessels disease group. The severity degree of coronary artery stenosis was quantitively assessed according to coronary angiography by Gensini score.They were divided into four groups according to Gensini score: normal control group, Gensini score<30 group,30-60 group and≥60 group.They were divided into three groups according to body mass index:normal body weight group,overweight group and obesity group.They were divided into three groups according to fasting blood glucose:normal blood glucose group,impaired fasting glucose group and diabetes group. Serum levels of adiponectin and YKL-40 of different groups were measured by enzyme-linked immunosorbent assay. Correlation between serum levels of adiponectin and YKL-40 and Gensini score was analyzed.Results 1.Serum adiponectin concentrations in patients with coronary heart disease were significantly lower than those in control group(P < 0.01), serum YKL-40 concentrations in patients with coronary heart disease were significantly higher than those in contral group(P<0.01).2.Patients in AMI group and UAP group and SAP group had lower serum adiponectin concentrations than those in control group(P<0.05 or P<0.01) ,patients in AMI group and UAP group had lower serum adiponectin concentrations than those in SAP group(P<0.01), no significant difference was found between UAP group and AMI group(P>0.05). Patients in AMI group and UAP group and SAP group had higher serum YKL-40 concentrations than those in control group(P<0.05 or P<0.01), patients in AMI group and UAP group had higher serum YKL-40 concentrations than those in SAP group(P<0.01), no significant difference was found between UAP group and AMI group(P>0.05).3.Serum adiponectin concentrations were decreased in turn among normal control group,single vessel disease group,double vessels disease group and three vessels disease group(P<0.05 or P<0.01). Serum YKL-40 concentrations were increased in turn among normal control group,single vessel disease group,double vessels disease group and three vessels disease group(P<0.05 or P<0.01).4.As Gensini score increased, serum adiponectin concentrations decreased(P<0.05 or P<0.01),serum YKL-40 concentrations increased(P<0.05 or P<0.01).5. Serum adiponectin concentrations were negatively correlated with Gensini score(r=-0.686,P<0.01), serum YKL-40 concentrations were positively correlated with Gensini score(r=0.679,P<0.01).6.Serum adiponectin concentrations in overweight group and obesity group were lower than those in normal body weight group(P<0.05 or P<0.01), serum adiponectin concentrations in obesity group were lower than those in overweight group(P<0.05), serum YKL-40 concentrations in overweight group and obesity group were higher than those in normal body weight group(P<0.05),no significant difference was found between overweight group and obesity group(P>0.05).7. Serum adiponectin concentrations in impaired fasting glucose group and diabetes group were lower than those in normal blood glucose group(P<0.05 or P<0.01),no significant difference was found between impaired fasting glucose group and diabetes group(P>0.05), serum YKL-40 concentrations in impaired fasting glucose group and diabetes group were higher than those in normal blood glucose group(P<0.05 or P<0.01),no significant difference was found between impaired fasting glucose group and diabetes group(P>0.05).Conclusions 1.Serum levels of adiponectin and YKL-40 were correlated with coronary heart disease,serum levels of adiponectin in patients with CHD decreased but serum levels of YKL-40 increased.2.Serum levels of adiponectin and YKL-40 were correlated with different clinical types of CHD,serum levels of adiponectin decreased and serum levels of YKL-40 increased in patients with acute coronary syndrome,that suggested adiponectin and YKL-40 perhaps participated in occurrence of instability of atherosclerotic plaque.3.Serum levels of adiponectin and YKL-40 were correlated with severity of coronary artery lesion.The more serious coronary artery lesions were,the lower adiponectin levels were and the higher YKL-40 levels were.4. Serum levels of adiponectin and YKL-40 were correlated with obesity and hyperglycosemia,patients with obesity or hyperglycosemia had lower adiponectin levels and higher YKL-40 levels, adiponectin and YKL-40 perhaps influenced development of atherosclerosis and CHD indirectly through obesity and hyperglycosemia.