Regular ArticleLevels of the adipocyte-derived plasma protein, adiponectin, have a close relationship with atheroma
Introduction
Atherosclerosis involves a combination of fatty degeneration (atheroma) and vessel stiffening (sclerosis) of the arterial wall [1]. Atheroma is closely associated with high levels of cholesterol with lipid-rich atheromatous plaques contributing to vascular obstruction and end-organ damage [2], [3], and it is well established that lipid lowering therapy reduces the progression of the vascular lesions [4]. In contrast, the role of sclerosis in coronary artery diseases (CAD) is less clear and has attracted considerably less attention mainly as a result of there being little evidence of end-organ damage due to sclerosis alone. In addition, it is relatively difficult to obtain an assessment of sclerosis [2], as it is influenced by a diverse number of factors including age, blood pressure, diabetes, and renal function [5], [6], [7], [8].
Adiponectin is an adipocyte-specific protein abundantly present in human plasma, which has been proposed to play an important role in the development of atherosclerosis [9], [10], [11], [12]. There is evidence that physiological concentrations of adiponectin dose-dependently inhibit tumor necrosis factor-α-mediated expression of adhesion molecules produced during the early stage of atherosclerosis that include vascular cell adhesion molecule-1, endothelial–leukocyte adhesion molecule-1, and intracellular adhesion molecule-1 [13]. Adiponectin therefore has potential antiatherosclerotic effects in addition to having a protective role against neointimal formation in humans [14], [15].
The development of high-resolution ultrasonography has facilitated the noninvasive evaluation of structural changes in the carotid arterial wall including detection of focal plaques. These changes are measured as the intima-media thickness (IMT) that is considered as an index of atheroma [7]. Recent developments have also enabled simple measurement of brachial and ankle pulse wave velocity (baPWV) by simultaneous monitoring using a phonocardiogram, electrocardiogram, and both sides of brachial and ankle pressure waveforms [16]. Distensibility of the arteries can be assessed by functional changes in PWV, providing an index of sclerosis [17]. Low-grade chronic inflammation is also an important factor in atherosclerosis and is indicated by elevated levels of plasma C-reactive protein (CRP) [18]. In the present study, we hypothesized that plasma adiponectin levels were closely associated with atherosclerotic vascular changes involved in inflammation.
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Study population
We studied 250 patients who underwent diagnostic catheterization (164 men and 86 women, mean age 68±9, range 40–89 years). The group with CAD consisted of 142 patients whose coronary angiography showed 50% or greater narrowing of the major coronary arteries. The control group consisted of 108 patients matched for age, sex, and body mass index (BMI) with the CAD group, who had atypical chest pain at rest, or following minimal exercise associated with coronary spasm or 25% or less narrowing of
Patient characteristics
The clinical characteristics of the study patients are summarized in Table 1 that shows that there were significant differences in pulse pressure, the incidence of glucose intolerance and HDL-C levels in the two groups. Plasma levels of CRP were significantly higher, and plasma levels of adiponectin were significantly lower in the CAD group compared to the control group. The CAD group had significantly higher IMTmax and bilateral baPWV than the control group (Table 2).
The correlation between plasma adiponectin levels and other parameters
The linear relationships
Discussion
Our results confirm the findings of other studies that have shown that plasma adiponectin levels are lower in males and in patients with CAD, obesity, diabetes, or hypertriglyceridemia and are higher in subjects with normal or elevated levels of HDL-C [9], [21]. Weyer et al. found that plasma adiponectin levels were also lower in patients with IGT as well as diabetes compared with normal subjects [22]. On the basis of these results, we classified individuals with either diabetes or IGT as being
Acknowledgements
We gratefully acknowledge the technical assistance of Sachiyo Tanaka and Megumi Tsukamoto. This work was supported in part by grants for Clinical Vascular Function, Japan, Research Meeting on Hypertension and Atherosclerosis, Japan, and by grants-in-aid B(2)-14770319, C(1)-12203001, C(2)-13670727, and 14770318 from the Ministry of Education, Science, and Culture, Japan and the Smoking Research Foundation, Japan.
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