title: Determinants of serum high molecular weight (HMW) adiponectin levels in patients with coronary artery disease: associations with cardio-renal-anemia syndrome.
abstract: OBJECTIVE
  A low serum adiponectin level is associated with a high incidence of coronary artery disease (CAD) in the healthy population. Paradoxically, serum adiponectin is elevated in patients with severe CAD or chronic heart failure. We investigated the determinants of serum high molecular weight (HMW) adiponectin in patients with CAD.
  
  
  METHODS
  We studied 228 consecutive patients with CAD confirmed by angiography. Anemia was defined as a hemoglobin of <13.0 g/dL in men and<12.0 g/dL in women. A high plasma B-type natriuretic-peptide (BNP) was defined as >100 pg/mL. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min for more than 3 months. The patients with CAD were divided into eight groups according to the presence or absence of anemia, high BNP, and/or CKD.
  
  
  RESULTS
  In all 228 patients with CAD, serum HMW adiponectin correlated positively with age, high-density-lipoprotein cholesterol (HDL-C), and BNP, while this parameter showed negative correlations with body mass index, insulin resistance, triglycerides, eGFR, and hemoglobin. Multivariate analysis showed that HDL-C, BNP, gender, and age were independently associated with the HMW adiponectin. Serum HMW adiponectin was lower in CAD patients with than without metabolic syndrome. Serum HMW adiponectin and the HMW/total adiponectin ratio were highest in CAD patients who had anemia, high BNP, and CKD among the groups.
  
  
  CONCLUSIONS
  In patients with CAD, metabolic syndrome is associated with a lower serum HMW adiponectin, while the presence of anemia, high BNP, and CKD is associated with elevation of the serum HMW adiponectin.
authors.affiliation: Department of Internal Medicine, Koshigaya Hospital, Dokkyo Medical University, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Hara
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Uchida
authors.forename: Kohzo
authors.initials: K
authors.lastname: Takebayashi
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Sakai
authors.forename: Teruo
authors.initials: T
authors.lastname: Inoue
authors.forename: Toshiko
authors.initials: T
authors.lastname: Inukai
authors.forename: Kan
authors.initials: K
authors.lastname: Takayanagi
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Aso
mesh_terms: D052242:Adiponectin / Q000097:blood* / Q000737:chemistry; D000368:Aged; D000740:Anemia / Q000097:blood* / Q000150:complications*; D015415:Biomarkers / Q000097:blood / Q000737:chemistry; D059347:Cardio-Renal Syndrome / Q000097:blood* / Q000150:complications*; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications; D008875:Middle Aged; D008970:Molecular Weight; D020097:Natriuretic Peptide, Brain / Q000097:blood; D013577:Syndrome
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; D020097:Natriuretic Peptide, Brain