High serum levels of adiponectin improve coronary collateral development in patients with coronary artery disease.

摘要

Adiponectin is a novel polypeptide that modulates endothelial function. Association between high serum adiponectin level and stimulation of new blood vessel formation have been reported in two experimental studies, however, data in humans are lacking. We sought to determine relationship between serum adiponectin and collateral vessel development in patients with coronary artery disease. We included 89 patients with stable angina pectoris and angiographically documented total occlusion in one of the major coronary arteries. Coronary collateral circulation was graded according to Rentrop scoring method in which collateralisation was graded between 0 and 3 from the poorest to the best. Adiponectin was determined by the ELISA method. High serum adiponectin level were significantly associated with increased new collateralisation (p = 0.001). With the increase of body mass index and waist circumference, the collateral development decreased (p = 0.001, p = 0.002; respectively). Presence of the diabetes mellitus (DM) was more frequent in those with poor collateral group than in those with good collateral group. DM was associated with poor collateral development (p = 0.002). In multiple stepwise logistic regression analysis, low level of serum adiponectin (p = 0.0001), waist circumference (p = 0.001), and presence of DM (p = 0.003) were found to be significant independent predictors of poor collateral formation. In conclusion, we have shown for the first time that elevated levels of serum adiponectin are associated with coronary collateral development in patients with coronary artery disease and additionally, the present study confirms many of the metabolic associations reported previously with adiponectin.