Determinants of Serum High Molecular Weight (HMW) Adiponectin Levels in Patients with Coronary Artery Disease: Associations with Cardio-renal-anemia Syndrome

Abstract

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. 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. 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. 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.