Coronary atherosclerosis : adiponectin and leptin as predictors of disease severity

Abstract EN

Adipose tissue is known to produce and release numerous bioactive substances, known as adipokines (such as leptin and adiponectin), which have been found to be involved in various physiological processes, including the regulation of arterial tone and they are related to cardiovascular risk factors.

The objective of the present study was to determine the relationship between the levels of serum leptin and adiponectin and the degree of coronary heart disease, also, to compare the sensitivity and specificity of serum circulating levels of the these two biomarkers in CAD diagnosis.

Forty nine patients with established coronary artery disease (CAD) defined as old myocardial infarction and angina pectoris classified as CAD group.

The control group included twenty normal healthy subjects.

All patients and controls were subjected to complete clinical history taking, clinical examination including 12 lead electrocardiograms (ECG), diagnostic coronary angiography (CA) and the colorimetric measurement of serum levels of triacylglycerols (TGs), total cholesterol (total-C), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), also, ELISA for measurement of leptin and adiponectin.

The predictors of coronary atherosclerosis severity include higher LDL-C, low serum adiponectin level, higher leptin level and previous myocardial infarction.

Serum levels of leptin, LDL-C and total-C showed highly significant (p< 0.0001) increase, while, adiponectin levels showed highly significant (p< 0.0001) decrease in the group of patients when compared to the levels of the control group.

The levels of HDL-C in the group of patients were significantly (p< 0.05) lower than in the control group.

There was no significant difference between the levels of TGs in the patients versus the controls.

The levels of leptin showed negatively significant correlation with the levels of adiponectin (r=0.76, p<0.001), it was positively significant with the levels of LDL-C (r=0.302, p=0.035), while, there was no significant correlation between the levels of leptin and HDL-C and the levels of adiponectin and HDL-C, there was a weak but significant correlation between the levels of serum adiponectin and LDL-C (r=0.2, p=0.001).

The overall positive rates obtained from Receiver Operating Characteristic (ROC) curve for evolution of sensitivity and specificity of the different biomarkers is obtained.

The sensitivity was 100% for both leptin and adiponectin.

ROC curve results revealed that the specificity for leptin and adiponectin were 100% and 90%, respectively.

The results obtained in the present study indicate that serum leptin and adiponectin might play an important pathogenic role not only in the occurrence but also in the severity of CAD.

The circulating level of leptin provides highly specific biomarker for CAD more than adiponectin.