Statins combined with exercise are associated with the increased renal function mediated by high-molecular-weight adiponectin in coronary artery disease patients.
BACKGROUND
Statins and exercise therapy are clinically effective in preventing cardiovascular events in patients with coronary artery disease (CAD). The aim of this study was to determine the effects of statins combined with exercise on the renal function of CAD patients.


METHODS
We performed a sub-analysis of a clinical trial that determined the 20-week-effects of two statins (rosuvastatin, n=14; atorvastatin, n=14) combined with regular exercise on renal function, as assessed by the estimated glomerular filtration rates (eGFRs) of CAD patients.


RESULTS
The combination of statins and exercise therapy increased eGFRs from 61.1±16.6 at baseline to 65.8±16.8ml/min/per 1.73m(2) (p=0.03), increased serum levels of high-molecular-weight (HMW) adiponectin, increased ubiquinol/low-density lipoprotein cholesterol (LDL-C) ratios, and decreased high sensitivity C-reactive protein (hs-CRP). Changes in HMW-adiponectin, ubiquinol/LDL-C ratios and hs-CRP were significantly correlated with changes in eGFR (r=0.597, p=0.001; r=0.437, p=0.02; and r=-0.473, p=0.01, respectively). Treatment-induced increases in HMW-adiponectin independently correlated with the increases in eGFR (β=0.513, p=0.02) in a multivariate analysis. Both atorvastatin and rosuvastatin combined with regular exercise produced increases in eGFR. The patients treated with rosuvastatin exhibited significant improvements in eGFR.


CONCLUSIONS
Statins combined with exercise significantly increased eGFR in CAD patients, and these improvements in renal function were correlated with increases in HMW-adiponectin levels. The statins-exercise combination treatment may have provided clinical benefits for patients with CAD partly through the improvement in renal function.
Department of Cardiovascular Medicine, Faculty of Life Science, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Japan Society for the Promotion of Science, Tokyo, Japan; Division of Cardiology, Health Insurance Hitoyoshi General Hospital, Kumamoto, Japan.
Kensuke
K
Toyama
Department of Cardiovascular Medicine, Faculty of Life Science, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan. Electronic address: ssugiyam@kumamoto-u.ac.jp.
Seigo
S
Sugiyama
Division of Cardiology, Health Insurance Hitoyoshi General Hospital, Kumamoto, Japan.
Hideki
H
Oka
Clinical Research Center, Health Insurance Hitoyoshi General Hospital, Kumamoto, Japan.
Yuri
Y
Iwasaki
Division of Cardiology, Kumamoto Central Hospital, Kumamoto, Japan.
Hitoshi
H
Sumida
Division of Preventive Cardiology, Department of Cardiovascular Medicine, Kumamoto University Hospital, Kumamoto, Japan.
Tomoko
T
Tanaka
Division of Cardiology, Health Insurance Hitoyoshi General Hospital, Kumamoto, Japan; Division of Preventive Cardiology, Department of Cardiovascular Medicine, Kumamoto University Hospital, Kumamoto, Japan.
Shinji
S
Tayama
Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan; Division of Preventive Cardiology, Department of Cardiovascular Medicine, Kumamoto University Hospital, Kumamoto, Japan.
Hideaki
H
Jinnouchi
Department of Cardiovascular Medicine, Faculty of Life Science, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Hisao
H
Ogawa
D052242:Adiponectin / Q000097:blood*; D000368:Aged; D000369:Aged, 80 and over; D000069059:Atorvastatin; D015415:Biomarkers / Q000097:blood; D003131:Combined Modality Therapy; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D005081:Exercise Therapy; D005260:Female; D005464:Fluorobenzenes / Q000627:therapeutic use; D005919:Glomerular Filtration Rate; D006538:Heptanoic Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D015999:Multivariate Analysis; D011446:Prospective Studies; D011743:Pyrimidines / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000627:therapeutic use
D052242:Adiponectin; D015415:Biomarkers; D005464:Fluorobenzenes; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D000069059:Atorvastatin
Coronary artery disease; Exercise; Kidney disease; Statins