Plasma adiponectin as a predictor of the effectiveness of coronary heart disease therapy in patients with metabolic syndrome

Abstract

BACKGROUND: Adiponectin, an adipose tissue protein, plays a crucial role in the development of metabolic syndrome and atherosclerosis. As a potential therapeutic target, this adipokine can be considered in the context of treatment strategies. AIM: The aim of this study was to assess the correlation between changes in plasma adiponectin concentration during coronary heart disease therapy and the effectiveness of the treatment, as well as to examine the relationship between initial adiponectin levels and treatment outcomes in patients with metabolic syndrome. MATERIALS AND METHODS: The study included 31 patients with coronary heart disease and metabolic syndrome (age 59.7 5.9 years, 21 women) which underwent the reexamination after 23 years. Most patients received statins (n = 26), while some received fibrates (n = 4) and hypoglycemic drugs (n = 4). Additionally, the patients were on hypotensive and antithrombotic therapies. The effectiveness of coronary heart disease therapy was assessed by evaluating changes in the functional class of angina pectoris and exercise tolerance measured through cycle ergometry. Plasma samples were collected at the initial and reexamination periods to determine glucose, insulin, adiponectin, leptin, and lipidogram parameters. RESULTS: The study revealed improvements in insulin sensitivity and plasma lipid spectrum, along with reduced levels of plasma leptin and increased adiponectin levels during the course of therapy. In addition, some patients showed enhanced exercise tolerance. Among the biochemical parameters, changes in insulin resistance during therapy correlated with improvements in exercise performance indicators during cycle ergometry (r = 0.320.36, p 0.05). Moreover, multiple regression analysis indicated that the initial adiponectin concentration independently determined changes in inotropic reserve and the amount of work performed ( = 0.44, p = 0.04 and = 0.64, p = 0.008). CONCLUSIONS: The studys findings regarding the association of plasma adiponectin concentration with changes in exercise tolerance during coronary heart disease therapy suggest the potential for developing specific approaches to raise adiponectin levels in the future.