Povezanost nivoa adiponektina u serumu pacijenata u zavisnosti od metaboličkog sindroma i koronarne bolesti

Abstract

Dosadašnje studije potvrđuju da adiponektin, protein koji luče adipociti, ostvaruje kardiovaskuloprotektivnu, antiaterogenu, anti- inflamatornu, antiadhezivnu, vazodilatatornu, antikataboličku i antidijabetičnu ulogu. Hipoadiponektinemija doprinosi patofiziologiji metaboličkog sindroma i koronarne bolesti, čak može biti nezavistan kardiovaskularni faktor rizika. Nivo adiponektina u serumu može biti rani marker ovih entiteta, metaboličkog sindroma i koronarne bolesti. Metod: Kliničko-laboratorijska studija preseka obuhvatila je 100 ispitanika oba pola sa metaboličkim sindromom i koronarnom bolešću. Korišćene su sledeće metode: klinički pregled, antropometrijska merenja, određivanje ukupne količne masnog tkiva osteodenzitometrijom, labora- torijska ispitivanja [koncentracija adiponektina u serumu ELISA metodom, insulina RIA metodom, glikemija OGTT-om, lipidni parametri (HOL, HDL, LDL, trigliceridi) i C-reaktivni protein], elektrokardiogramsko, ehokardiografsko merenje, analiza koronarografskih nalaza i izračunavanje aterogenih i HOMA-indeksa. Rezultati: Nivo adiponektina je u negativnoj korelaciji sa parametrima metaboličkog sindroma (gojaznost, hipertenzija, hiperglikemija i insulinska rezistencija, dislipidemija) i koronarne bolesti (broj suženja koronarnih arterija i progresija bolesti) i u pozitivnoj korelaciji sa ejekcijonom frakcijom, dijastolnom funkcijom i HDL-holesterolom. Adiponektin može biti značajan prediktor metaboličkog sindroma i koronarne bolesti i rani reprezentativni marker miokardne ishemije i vaskularne inflamacije, a hipoadiponektinemija nezavistan kardiovaskularni faktor rizika. Zaključak: Studija, prva te vrste u Srbiji, a jedna od retkih u svetu, daće značajan doprinos izučavanju adiponektina kao ranog reprezentativnog, dijagnostičkog i prediktivnog markera kod bolesnika sa metaboličkim sindromom i koronarnom bolešću.

Up to date studies are confirming that adiponectin, a cytokine produced by adipocytes, exerts cardiovascular-protective role including antiatherogenic, anti-inflammatory, anti-adherent, vasodilator, anticatabolic and antidiabetic effects. Hypoadiponectinaemia contributes to the pathophysiology of the metabolic syndrome and coronary artery disease. The level of adiponectin in serum may be seen as an independent cardiovascular risk factor. In addition, the level of circulating adiponectin may be an early marker of the conditions such as metabolic syndrome and coronary artery disease. Methods: This research represents the clinical-laboratory cross-sectional study, based on the cases of 100 patients of both sexes with metabolic syndrome and/or coronary artery disease. Following methods were used: a clinical examination, anthropometric measurements, determine the total amounts of the fatty tissue osteodensitometry; laboratory testing included concentration of adiponectin in serum utilising super-sensitive sandwich ELISA-method, insulin level measured by RIA-method, glycemia OGTT-test, lipid parameters (HOL, HDL, LDL, triglycerides) and C-reactive protein, gained by standard routine biochemical protocols. All of the examinees were subjected to electrocardiogram and ehocardiogram measurement, the analysis of graphs-coronary graphically findings and calculation of atherogenic and HOMA-index. Results: The level of adiponectin showed statisticaly significant negative correllation with the key parameters of metabolic syndrome (obesity, hypertension, hyperglycemia, dyslipidemia and insulin resistance), as well as coronary artery disease. More accurately, the level of adiponectin is decreasing exact number of coronary arteries disease and simptomatology progression. Plasma levels of adiponectin positively correlated with ejection fraction, diastolic function and HDL-cholesterol. Adiponectin may be a significant predictor of metabolic syndrome and coronary heart disease, and an early representative marker of myocardial ischemia and vascular inflammation, as well as hypoadiponectinaemia independent cardiovascular risk factor. Conclusion: This study, the first of its kind in Serbia and one of the few in the world, will significantly contribute to acknowledgement of the role of adiponectin as an early representative, diagnostic and predictive markers in patients with metabolic syndrome and coronary artery disease.