Relationship of adiponectin and leptin to coronary artery disease, classical cardiovascular risk factors and atherothrombotic biomarkers in the IARS cohort

Jayashree Shanker; Veena S. Rao; Vandana Ravindran; Bhaskar Dhanalakshmi; Sridhara Hebbagodi; Vijay V. Kakkar

doi:10.1160/TH12-04-0263

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2012; 108(04): 769-780
DOI: 10.1160/TH12-04-0263

New Technologies, Diagnostic Tools and Drugs

Schattauer GmbH

Relationship of adiponectin and leptin to coronary artery disease, classical cardiovascular risk factors and atherothrombotic biomarkers in the IARS cohort

Jayashree Shanker

¹Mary & Garry Weston Functional Genomics Unit, Thrombosis Research Institute India, Bangalore, India

,

Veena S. Rao

²Tata Proteomics & Coagulation Unit, Thrombosis Research Institute India, Bangalore, India

,

Vandana Ravindran

³Elizabeth & Emmanuel Kaye Bioinformatics and Statistics Unit, Thrombosis Research Institute India, Bangalore, India

,

Bhaskar Dhanalakshmi

⁴Clinical Research Unit, Thrombosis Research Institute India, Bangalore, India

,

Sridhara Hebbagodi

³Elizabeth & Emmanuel Kaye Bioinformatics and Statistics Unit, Thrombosis Research Institute India, Bangalore, India

,

Vijay V. Kakkar

⁵Scientific Chairman and Managing Trustee, Thrombosis Research Institute India, Bangalore, India

⁶President, Thrombosis Research Institute, London, UK

› Institutsangaben

Abstract

Summary

Adiponectin and leptin link metabolic disorders and coronary artery disease (CAD). We analysed their relationship with CAD, classical risk factors and biomarkers in 287 CAD patients (cases) and 477 unaffected family members (controls) selected from the Indian Atherosclerosis Research Study (IARS). Classical risk factors included diabetes, hypertension, dyslipidaemia and obesity markers. Novel biomarkers were measured according to manufacturer recommendations. Adverse clinical events were recorded through telephonic follow-up. Cases showed lower adiponectin levels (4684.62 ± 190.73 ng/ml) than controls (5768.86 ± 152.87 ng/ml) (p=1.58X10^–5); Leptin levels were higher in affected males (12.47 ± 1.32 ng/ml) than in male controls (9.53 ± 1.19 ng/ml, p=0.017). Adiponectin 1^st quartile showed significant protection against CAD in females when compared to 3^rd (odds ratio [OR] 0.39, 0.16–0.92, p=0.032) or 4^th (OR 0.32, 0.14–0.72; p=0.006) quartile group. Leptin 3^rd quartile showed higher CAD risk in males as compared to 1^st quartile group (OR 2.09, 1.09–4.01, p=0.028). Subjects with metabolic syndrome showed low adiponectin and high leptin levels. Adipokines showed opposing association trend with lipids, inflammatory and coagulation markers and strong correlation (r=-0.14 to 0.52) with obesity markers. Cases with recurrent event and controls who developed new cardiac event during follow up showed high adiponectin levels (p<0.05). A model that combined adiponectin, leptin and conventional risk factors yielded the best ‘C’ index (0.890, 0.067–0.912). CAD patients in the top adiponectin tertile showed relatively poor survival curve as compared to the bottom Adiponectin tertile group. In conclusion, our findings strengthen the reported association between low adiponectin, high leptin, obesity-related metabolic disturbances and incident CAD in Asian Indians.

Keywords

Adiponectin - leptin - coronary artery disease - biomarkers - Asian Indians

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Referenzen

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