Changes And Its Correlation Of Serum Adiponectin And The Ankle-Brachial Index In Patients With Acute Coronary Syndrom

Objectives:To observe the changes and correlations of the serum adiponectin (APN) and the ankle-brachial index (ABI) in patients with acute coronary syndrome (ACS) and assessment their value of the ACS.Mehtdos:We detected the APN by enzyme-linked immunosorbent assay (ELISA), measured the ABI by automatic instrument for disease of atherosclerosis, and made the coronary angiography through the method of Seldingers.69 cases of coronary heart disease (CHD) were divided into two groups, that is the ACS group (n=44) and the stable angina pectoris (SAP) group (n=25), based on the clinical manifestations and coronary angiography. Also they were divided into three groups including the single -vessel group (n=25), the double -vessel group (n=20), and the three -vessel group (n=24), according to the number of the pathologically involved vessels. Meanwhile they were divided into the 1～30 group (n=48) and the≥30 groups (n=21) by the score of Gensini integral.22 patients who demonstrated normal images by coronary angiography were selected as the normal control group. SPSS 13.0 for Windows was used for statistical analysis. All the count data were analyzed with x2 test. All the measurement data showed by the form of the mean±standard deviation ((?)±s) were compared by t test between two groups and by analysis of variance among more that three groups. The relationship between variables by correlation analysis.Results:1) The APN showed lower expression in the ACS group than both the SAP group [(1.80±1.35) mg/l vs (7.04±4.62)mg/l] and the control group[(1.80±1.35)mg/l vs (9.51±4.41)mg/l],which indicated significant difference (P<0.01), while there was no significant difference between the SAP group and the control group (P>0.05). The ABI test showed lower value in the ACS group than both in SAP group [(0.92±0.10) vs (1.02±0.11)],and the control group [(0.92±0.10) vs (1.09±0.12)], which indicated significant difference (P<0.01), while there was no significant difference between the SAP group and the control group (P>0.05). The ACS group showed much more ABI values≤0.9 than the other groups, and the statistical analysis showed the percentage of 38.64%(17/44)2) As far as the groups divided by the number of involved vessels were concerned, the APN in the three -vessels group showed the lowest among four groups, the double-vessels group[(1.03±1.21)mg/l vs (2.17±1.49)mg/l]showing and the single-vessel group[(1.03±1.21)mg/l vs (7.50±3.95)mg/l] and the control group[(1.03±1.21)mg/l vs (9.51±4.41)mg/l];respectively,indicating significant difference (P<0.01). It showed lower in the double-vessels group than both in the single-vessel group and the control group, indicating significant difference (P<0.01). It showed no significant difference between the single-vessel group and the control group (P>0.05). The correlation analysis suggested a negative correlation between the APN and the number of vessels involved (r=-0.733, p<0.01). The ABI values in the three -vessels group was lower than the other three groups, the double -vessels group[(0.86±0.08) vs (0.99±0.09)]showing, the single-vessel group [(0.86±0.08) vs (1.04±0.10)]and the control group [(0.86±0.08) vs (1.10±0.12)] respectively, which indicated significant difference (P<0.01). It showed a lower value in the two-vessel group than the control group, indicating a significant difference (P<0.01). It showed no significant difference between the both double-vessels group and single-vessel group,the single-vessel group and the control group (P> 0.05). The three-vessels group showed much more ABI values≤0.9 than the other groups, and the statistical analysis showed the percentage of 50%(12/24). The correlation analysis suggested a negative correlation between the ABI and the number of vessels involved (r=-0.632, p<0.01).3)As far as the score of Gensini was concerned, the APN showed lower in the≥30 group than both the<30 group[(1.23±1.04)mg/l vs (4.78±4.18)mg/l]and the control group [(1.23±1.04) mg/1 vs (9.51±4.41)mg/l], indicating significant difference (P<0.01); It was lower in the <30 group than the control group, indicating significant difference (P<0.01). The correlation analysis suggested a negative relevance between with the APN the Gensini score (r=-0.640, p<0.01). The ABI values in the≥30 group was lower than both the<30 group [(0.85±0.07) vs (1.00±0.10)]and the control group [(0.85±0.07) vs (1.10±0.12)], indicating significant difference (P<0.01). It was lower in the<30 group than the control group, indicating significant difference (P<0.01). The three -vessels group showed much more ABI values≤0.9 than the other groups, and the statistical analysis showed the percentage of 71.43% (15/21). The correlation analysis suggested a negative relevance beween the value of ABI and the Gensini points (r=-0.697, p<0.01).Conclusions:1) The APN and ABI showed lower expression in the ACS group than both the SAP group and the control group, the lower the adiponectin levels and the value of ABI may be higher of ACS rate.2) Both the Serum APN levels and the value of ABI increased with the severity of coronary lesions and reduce the expansion of the scope, the lower the adiponectin levels and the value of ABI, the more may be serious lesions and larger lesions.