Plasma adiponectin as a predictor of the effectiveness of CHD therapy in patients with metabolic syndrome

Abstract

Background. Adiponectin (AN) is an adipose tissue protein that affects the development of metabolic syndrome (MS) and atherosclerosis. In this regard, this adipokine can be considered as a possible therapeutic target. Aim. The aim was to determine to what extent the change in plasma AN concentration during the treatment of coronary heart disease (CHD) as well as the AN concentration at the start of the therapy correlate with the effectiveness of CHD treatment in patients with MS. Materials and methods. Thirty-one patients with CHD and MS (age 59.75.9 years, 21 women) which had the reexamination after 2-3 years were selected for the study. Most patients received statin therapy (n=26), several patients took fibrates (n=4), hypoglycemic drugs (n=4). The patients also received hypotensive and antithrombotic therapy. The effectiveness of CHD therapy was assessed by changes in the functional class of angina pectoris and indicators of exercise tolerance in cycle ergometry. The levels of glucose, insulin, AN, leptin, and lipidogram parameters were determined in blood plasma samples during at the initial and reexamination period. Results. During therapy, the insulin sensitivity and plasma lipid spectrum were improved, the concentration of leptin in plasma was reduced while the adiponectin levels were increased. In addition, in some patients there was an improving in exercise tolerance. Among the biochemical parameters, only a change in insulin resistance during therapy correlated with an improvement in the exercise performance indicators during cycle ergometry (r = -0.32 -0.36, p0.05). At the same time, according to multiple regression analysis, the initial AN concentration was an independent determinant of changes in the inotropic reserve and the amount of work performed (=0.44, p=0.04 and =0.64, p=0.008). Conclusion. The revealed relationship of plasma AN concentration with changes in exercise tolerance in the course of CHD therapy provide the basis for future development of specific ways for rising the levels of this adipokine.