Influence of abnormal glycometabolism on adiponectin level after acute myocardial infarction treated with primary percutaneuos coronary intervention

Abstract

Objective To characterize the glucometabolic state of patients with acute myocardial infarction (AMI), and to investigate the influence of abnormal glycometabolism on adiponectin levels after the first acute myocardial infarction treated with primary percutaneuos coronary intervention. Methods Two hundred and six consecutive patients with ST-elevated myocardial infarction (STEMI) in Beijing Friendship hospital were enrolled from July 2010 to August 2011. Patients with non-diagnosed diabetes were performed oral glucose tolerance test(OGTT). Patients with AMI were divided into three groups according to glucometabolic state: NGT(normal glucose tolerance), IGR(impaired glucose regulation) and DM(Diabetes Mellitus). Blood samples were drawn before the invasive procedure, immediately after the invasive procedure, and at 24, 48, 72 h and 7days after AMI onset. Left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) were measured in all patients. Results (1) 28.2% patients had known type 2 diabetes mellitus before AMI. Of patients with no diabetes, 46.6% had impaired glucose regulation (IGR) and 10.8% had newly diagnosed diabetes. Of all patients with AMI, 79.4% had abnormal glycometabolism. (2) Compared with NGT and IGT group, the fasting blood glucose [(9.23±4.11)mmol/L, (6.37±1.81)mmol/L vs. (5.19±0.79)mmol/L, all P<0.05] and blood glucose immediately (11.50±4.40, 8.22±1.38 vs. 6.42±0.86, all P<0.05)at admission in DM group were significantly higher. LVEF of DM group was significantly lower than other groups(51.82%±7.02% vs. 54.70%±7.98%, 54.75%±7.72%, all P<0.05). Plasma adiponectin level in DM group before the invasive procedure, immediately after the invasive procedure, and at 48, 72 h and 7 days after AMI onset were lower than NGT group [(13.42±1.73) μg/ml vs. (15.37±1.73) μg/ml, (12.92±2.45) μg/ml vs. (14.71±1.61) μg/ml, (11.32±3.37) μg/ml vs. (12.48±2.64) μg/ml, (11.55±3.05) μg/ml vs. (13.13±2.55) μg/ml, (11.89±2.92) μg/ml vs. (13.56±2.36) μg/ml, all P<0.05]. Plasma adiponectin level in DM group before the invasive procedure, immediately after the invasive procedure and 72 h and 7 days after AMI onset were lower than in IGT group[(13.42±1.73) μg/ml vs. (15.61±1.60) μg/ml, (12.92±2.45) μg/ml vs. (14.76±1.65) μg/ml, (11.55±3.05) μg/ml vs. (12.61±2.13) μg/ml, (11.89±2.92) μg/ml vs. (13.18±2.04) μg/ml, all P<0.05]. Conclusions Compared with NGT and IGR groups, adiponectin in DM group is significantly lower. Plasma adiponectin levels after the invasive procedure in NGT, IGR and DM groups are significantly lower than before the invasive procedure. Plasma adiponectin is decreased to the lowest level at 24 h after AMI onset in NGT, IGR and DM patients. Key words: Adiponectin; Acute myocardial infarction; Abnormal glycometabolism