Relationship Between The Plasma Level Of Adiponectin And Homocysteine And Endothelial Function In Patients With Coronary Heart Disease

Background and Objective:Adiponectin(APN) is an adipocyte-specific plasma protein,and recent evidence suggeststhat adiponectin plays an important role in anti-inflammatory, anti-atherosclerotic andprotect vascular endothelial cells. Homocysteine(Hcy) is the intermediates ofmethionine metabolism in human body. Hcy is an independent risk factor ofcardiovascular heart disease and is known to increase the development ofatherosclerosis and cardiovascular disease. Hcy can damage the vascular endothelialcell function and as an inflammatory cytokines involved in vascularinflammation.Vascular endothelial injury is the key and initiating factor ofatherosclerosis,evaluation of endothelial function can help us know the risk ofcardiovascular disease and prediction of cardiovascular events in the patients ofcoronary heart disease. In this study,we observed the level of APN,Hcy in the plasma ofpatients with coronary heart disease,and analyzed the association of APN,Hcy levelswith the flow-mediated dilatation(FMD).Methods:133patients were enrolled in this study,including66coronary heart disease(CHD)patients and67without coronary heart disease by coronary angiography(CAG) ascontrol group(CG).Their age ranged from45to75.All of them had CAG in hospital.Wecollected clinical data such as age,gender,height,weight,smoking history,history ofhypertension and diabetes. Fasting glucose, triglycerides, total cholesterol, LDL cholesterol, HDL cholesterol were recorded when the patients come to the hospital.ELISA method were used to determine the plasma level of APN. ECLIA method wereused to determine the plasma level of Hcy.Endothelial function was measured using themethod of ultrasonic measurement of the brachial artery diameter change rate.B-modeultrasound was used to determine inner diameter of brachial arteries in basic state (D1)and the inner diameter after reactive hyperemia(D2),and then calculate the rates ofendothelium-dependent flow-mediated vasodilatation(FMD),FMD=(D2-D1)/D1.Results:FMD in patients with coronary heart disease group lower than the control group [(7.33±2.73)%vs.(12.14±3.27)%, p=0.016], the plasma APN levels of coronary heartdisease group lower than the level of the control group [(8.37±5.13) mg/L vs.(14.19±9.24) mg/L, p=0.021], plasma Hcy levels of coronary heart disease grouphigher than the control group [(15.88±3.91) umol/L vs (10.77±1.75) umol/L, p=0.004].Univariate analysis showed in the coronary heart disease group, age (r=-0.341,p=0.033), smoking history (r=-0.465, p=0.041), hypertension history(r=-0.862, p=0.002), diabetes history(r=-0.540, p=0.042), serum total cholesterol (r=-0.734, p<0.001), low-density lipoprotein cholesterol (r=-0.587, p=0.001), and plasma Hcylevels (r=-0.605, p=0.004)was negatively correlated with FMD，plasma APN levelsand FMD was positively correlated (r=0.871, p <0.001).Multiple linear regressionanalysis showed that it is independently correlation of patients with coronary arterydisease between hypertension history(X1), total cholesterol (X2), adiponectin (X3),homocysteine(X4) and FMD (Y).Conclusions:1.Endothelium-dependent vasodilation in patients with coronary heart disease wassignificantly reduced, accompanied by reduced levels of plasma APN and elevated Hcylevels, suggesting that the incidence of impaired endothelial function and changes incirculating blood levels of Hcy,APN and participate in coronary heart disease.2.APN plasma levels in patients with coronary heart disease and decreasedendothelium-dependent vasodilation was negatively correlated, Hcy levels and decreased endothelium-dependent vasodilation was positively correlated,lowercirculating APN level and higher Hcy levels are independent risk factor of endothelialdysfunction in patients with coronary artery disease, increased plasma APN levels anddecreased plasma Hcy levels may improve endothelial function in patients withcoronary heart disease, can benefit coronary heart patients.3.Traditional risk factors such as age, smoking, hypertension, diabetes disease, serumtotal cholesterol, low-density lipoprotein cholesterol levels was negatively correlatedwith endothelium-dependent vasodilation of the patients with coronary heart diseaseBy controlling these risk factors may improve coronary heart disease vascularendothelial function and prognosis.