Correlation Between Resistin, Cardiovascular Risk Factors, And Severity Of Coronary Stenosis In Patients With Acute Coronary Syndrome

Objectives: We sought to evaluate the correlation between serum resistin levels, cardiovascular risk factors, and the severity of coronary stenosis in patients with stable angina pectoris (SAP) and acute coronary syndrome (ACS).Background: Resistin is a recently identified adipocytokine which is strongly correlated with obesity and insulin resistance. Resistin is reported to enhance the expression of adhension molecules, affect endothelial function, and stimulate vascular smooth muscle cells migration. But few population-based data are available from subjects in ACS solely.Method: A total of 220 consecutive patients, who were evaluated by clinical history, electrocardiography (ECG), exercise tolerance tests (ETT), blood test and coronary angiography, were divided into normal control group, SAP group, and ACS group. Baseline clinical characteristics, including height, weight, waist circumference, hip circumference, white blood cells (WBC) counts, high-sensitive C-reactive protein (hsCRP) levels, total cholesterol (TC) levels, triglycerides (TG) levels, low-density lipoprotein cholesterol (LDL-c) levels, high-density lipoprotein cholesterol (HDL-c) levels, smoking habit and drinking habit, were collected prospectively by a dedicated cardiologist. The height, weight, waist circumference, and hip circumference of patients were measured when they enrolled in our institution. The WBC counts, hsCRP levels, and serum lipids levels were measured by the laboratory department of XinQiao hospital. Commercially available ELISA kits were used to detect serum resistin levels.Results:(1) There was significant difference in serum resistin levels between normal controls, SAP patients and ACS ones, while serum resistin levels were extremely high in ACS group (ACS vs. SAP/Controls: 1.18 vs. 0.66/0.49 ng/ml, p<0.01). After adusting for age and sex in patients, paired-samples t test showed that serum resistin levels in ACS group remained significantly higher than those in SAP group and control group (ACS vs. SAP/Controls: 1.16 vs. 0.72/0.49 ng/ml, p<0.01).(2) Serum resistin levels were associated with age (r=0.212, p=0.002), body mass index (BMI) (r=0.186, p=0.006), waist-to-hip ratio (WHR) (r=0.236, p=0.0004), WBC counts (r=0.342, p<0.001), hsCRP levels (r=0.362, p<0.001), TG (r=0.170, p=0.012), LDL-c (r=0.178, p=0.008) and HDL-c levels (r=-0.268, p<0.001).(3) When testing the correlation between serum resistin levels and cardiovascular risk factors in the three groups respectively, only in ACS group, serum resistin levels were remarkably associated with WBC counts (r=0.347, p=0.001), and hsCRP levels (r=0.262, p=0.004).(4) Furthermore, serum resistin levels showed correlation and stepwise increase with the numbers of >50% stenotic coronary vessels (p<0.01). Multinomial logistic regression test demonstrated that serum resistin levels were a strong risk factor in ACS (OR 29.132,95%CI:10.939-77.581,P<0.001).Conclusion: It can be concluded that, in our study population, serum resistin levels vary significantly in three different diagnosis groups and are extremely high in ACS patients. Moreover, serum resistin levels are highly correlated with atherosclerotic risk factors such as obesity, serum lipids, and systemic inflammation markers. Serum resistin levels are correlated with the severity of coronary stenosis and dependant on the number of >50% stenotic vessels. These findings support the potential role of resistin as a strong risk factor in the development of atherosclerosis and especially its involvement in the progress of ACS.