Adiponectin and E-selectin concentrations in relation to inflammation in obese type 2 diabetic patients with coronary heart disease(s).
OBJECTIVE
Adipose tissue is now regarded as a source of proinflammatory mediators which may contribute to vascular injury, insulin resistance (IR), and atherogenesis, however, some of them have a protective role against vascular inflammation and/or IR; namely adiponectin and nitric oxide (NO). Adiponectin is a fat derived hormone, which enhances insulin sensitivity. In experimental studies adiponectin was shown to have anti-atherogenic properties by suppressing endothelial expression of adhesion molecules as endothelial-selectin (E-selectin) and inflammatory cytokines as high-sensitivity C-reactive protein (hsCRP), interleukin-1β (IL-1β), and monocyte chemotactic protein-1 (MCP-1). Therefore, the aim of the study was to evaluate plasma adiponectin, E-selectin, hsCRP, IL-1β, and MCP-1 concentrations in obese patients with and without coronary heart disease (CHD) having type 2 diabetes mellitus (DM) and evaluation of their relationship with selected anthropometric, biochemical, and clinical parameters.


METHODS
The study group consisted of (N.=70) males, 20 of which served as healthy non-obese controls (group I) (mean age 38.5±3.7 years; mean BMI 28±1.2 kg/m2). Patients enrolled in the study were classified into the following groups: type 2 DM obese subjects without CHD (group II) (N.=25) (mean age 42.2±3 years; mean BMI 32.1±1.4 kg/m2) and type 2 DM obese subjects with CHD (group III) (N.=25) (mean age 40.6±3 years; mean BMI 31.5±1.2 kg/m2). Glucose and insulin estimation was performed and insulin resistance index (HOMA-IR) was calculated. In the fasting state, the plasma HbA1c, adiponectin, E-selectin, in comparison to hsCRP, IL-1β, MCP-1, and lipid parameters were estimated.


RESULTS
FBG, HbA 1c %, lipids, insulin, MDA, NO, hsCRP, IL-?, MCP-1, Adiponectin as well as E-selectin concentration were significantly different in patients with type 2 DM and CHD in comparison to patients without CHD and moreover, the healthy control group (P=0.01). There was a significant negative correlation between adiponectin and E-selectin (r=-0.642; P=0.0001).


CONCLUSIONS
Our study supports the hypothesis that decreased level of adipokine(s), together with increased oxidative stress, pro-inflammatory marker(s) as well as endothelial adhesion molecule(s) contributes to the complex process of atherosclerosis in type 2 diabetic obese patients that may lead eventually to CHD.
Biochemistry Department, Ain Shams University, Cairo, Egypt.
H O
HO
El-Mesallamy
N M
NM
Hamdy
T M
TM
Salman
S
S
Mahmoud
D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000465:Algorithms; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D018932:Chemokine CCL2 / Q000097:blood; D003327:Coronary Disease / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D019040:E-Selectin / Q000097:blood*; D018149:Glucose Intolerance; D006801:Humans; D007249:Inflammation / Q000097:blood; D007333:Insulin Resistance; D053583:Interleukin-1beta / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
D052242:Adiponectin; D015415:Biomarkers; D018932:Chemokine CCL2; D019040:E-Selectin; D053583:Interleukin-1beta; D002097:C-Reactive Protein