Comparison of plasma adiponectin & certain inflammatory markers in angiographically proven coronary artery disease patients with & without diabetes--a study from India.

Background & Objectives: The association between adiponectin and risk of cardiovascular disease is well known. The aim of the present study was to evaluate adiponectin and certain inflammatory markers and to determine the correlations between them in angiographically proven coronary artery disease (CAD) in subjects with and without diabetes.

Methods: A total of 180 subjects who underwent coronary angiography for symptoms suggestive of CAD were categorised into groups based on their diabetes and/or CAD status: group1 (non-diabetic non-CAD); group2 (non-diabetic CAD); group3 (diabetic non-CAD) and group4 (diabetic CAD). Adiponectin, tumour necrosis factor α (TNF-α) and soluble form of E-selectin (sE-selectin) were estimated using quantitative sandwich enzyme immunoassay and high sensitive C-reactive protein (hsCRP) by particle enhanced immunoturbidimetric method.

Results: Adiponectin levels were significantly lower in subjects with either diabetes or CAD and were much lower in subjects who had both. hsCRP was elevated in CAD and diabetes but did not differ significantly between groups. sE-selectin and TNF-α levels were elevated in CAD. Adiponectin negatively correlated with age, glucose, sE-selectin, total and LDL cholesterol. hsCRP correlated with BMI, sE-selectin and urea. sE-selectin correlated with BMI, triglycerides and VLDL cholesterol, whereas TNF-α correlated with fasting plasma glucose. In the logistic regression analysis, adiponectin had a significant inverse association with CAD. sE-selectin and TNF-α also showed significant independent association with CAD.

Interpretation & Conclusions: Adiponectin and other inflammatory markers such as sE-selectin and TNF-α showed a significant association with CAD. Hence, early assessment of such markers can help to identify high risk patients, and to reduce the inflammatory component of diabetes and CAD.