title: Circulating adipokines and insulin resistance in subjects with combined cardiac and metabolic syndrome X.
abstract: BACKGROUND
  Cardiac syndrome X (CSX) is characterized by angina pectoris but with patent coronary arteries. Our previous study showed that CSX subjects had decreased serum adiponectin but higher leptin and insulin resistance (IR). However, few studies have investigated circulating adipokines and IR in subjects with combined metabolic syndrome X (MetX) and CSX.
  
  
  METHODS
  Fifty-nine subjects with CSX were retrospectively enrolled from our cardiac catheterization patient databank. Fifty-four subjects with valvular heart disease or arrhythmia and with normal coronary angiograms were recruited as the non-CSX comparison group. The study subjects were reclassified according to the presence or absence of MetX. Circulating adipokines and degree of IR were measured.
  
  
  RESULTS
  Subjects with combined MetX and CSX had a significantly higher HOMA-IR, a higher circulating leptin level (median 8.7 vs. 3.3 ng/mL, p < 0.001), but a lower circulating adiponectin level (median 2.8 vs. 12.3 μg/mL, p < 0.001) than those without MetX and CSX. In pairwise comparisons, combined MetX and CSX subjects had a similar circulating adipokines and IR index as those who had only either one syndrome X. In a multivariate regression analysis, serum triglycerides (odds ratio 1.011, p = 0.024) and hypertension (odds ratio 14.453, p = 0.003) were independently associated with diagnosis of combined MetX and CSX.
  
  
  CONCLUSIONS
  Combined MetX and CSX had a significantly higher HOMA-IR, a higher circulating leptin but a lower circulating adiponectin level than those without MetX and CSX. Combined syndrome X did not confer more changes on adipokines or IR index comparing with those with only one syndrome X.
authors.affiliation: Cardiovascular Center, Taichung Veterans General Hospital, 1650 Taiwan Boulevard, Sec. 4, Taichung, 40705 Taiwan ; School of Medicine, National Yang Ming University, Taipei, Taiwan ; Department of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Kae-Woei
authors.initials: KW
authors.lastname: Liang
authors.affiliation: Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan ; Tung-Hai University, Taichung, Taiwan.
authors.forename: Wen-Jane
authors.initials: WJ
authors.lastname: Lee
authors.affiliation: Cardiovascular Center, Taichung Veterans General Hospital, 1650 Taiwan Boulevard, Sec. 4, Taichung, 40705 Taiwan ; School of Medicine, National Yang Ming University, Taipei, Taiwan.
authors.forename: Wen-Lieng
authors.initials: WL
authors.lastname: Lee
authors.affiliation: Cardiovascular Center, Taichung Veterans General Hospital, 1650 Taiwan Boulevard, Sec. 4, Taichung, 40705 Taiwan ; School of Medicine, National Yang Ming University, Taipei, Taiwan ; Taichung Tzu Chi Hospital, Taichung, Taiwan ; Department of Medicine, Tzu Chi University School of Medicine, Hualian, Taiwan.
authors.forename: Ying-Chieh
authors.initials: YC
authors.lastname: Liao
authors.affiliation: Cardiovascular Center, Taichung Veterans General Hospital, 1650 Taiwan Boulevard, Sec. 4, Taichung, 40705 Taiwan ; School of Medicine, National Yang Ming University, Taipei, Taiwan ; Department of Medicine, China Medical University, Taichung, Taiwan ; Department of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Kuo-Yang
authors.initials: KY
authors.lastname: Wang
authors.affiliation: School of Medicine, National Yang Ming University, Taipei, Taiwan ; Department of Medicine, Chung Shan Medical University, Taichung, Taiwan ; Division of Endocrinology and Metabolism, Department of Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard, Sec. 4, Taichung, 40705 Taiwan.
authors.forename: I-Te
authors.initials: IT
authors.lastname: Lee
authors.affiliation: School of Medicine, National Yang Ming University, Taipei, Taiwan ; Division of Endocrinology and Metabolism, Department of Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard, Sec. 4, Taichung, 40705 Taiwan.
authors.forename: Jun-Sing
authors.initials: JS
authors.lastname: Wang
authors.affiliation: School of Medicine, National Yang Ming University, Taipei, Taiwan ; Division of Endocrinology and Metabolism, Department of Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard, Sec. 4, Taichung, 40705 Taiwan ; Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan ; School of Medicine, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Wayne H-H
authors.initials: WH
authors.lastname: Sheu
keywords: Adiponectin; Cardiac syndrome X (CSX); Combined double syndrome X; Leptin; Metabolic syndrome X (MetX)