Adiponectin is a better predictor of endothelial function of the coronary artery than HOMA-R, body mass index, immunoreactive insulin, or triglycerides

Background: Previous studies have demonstrated that decreased levels of circulating adiponectin correlate with endothelial dysfunction in peripheral arteries. However, the relationship between adiponectin levels and endothelial function in coronary arteries remains unclear. The goal of the present study was to determine whether circulating adiponectin concentrations are a useful predictor of coronary endothelial function. Methods: Thirty-six consecutive non-diabetic patients with normal or mildly diseased coronary arteries were enrolled in this study. Coronary endothelial function was evaluated by coronary vascular response to acetylcholine (Ach). The relationship between coronary vasoreactivity and adiponectin or other biochemical or anthropometric parameters was investigated. The predictive value of adiponectin level for assessment of coronary endothelial dysfunction was assessed at the best cut-off point. Results: In a simple regression analysis, log-transformed adiponectin concentrations positively correlated with the percent change in coronary blood flow (CBF) and coronary artery diameter (CAD) induced by Ach (r = 0.62, p < 0.0001; r = 0.63, p < 0.0001, respectively). Insulin resistance index (HOMA-R), body mass index, immunoreactive insulin, and triglycerides concentrations also significantly correlated with the percent change in CBF and CAD. However, in a multiple regression analysis, log-transformed adiponectin concentration was the only independent predictor of the percent change in CBF and CAD (p < 0.0001; p < 0.0001, respectively). Furthermore, patients with adiponectin concentrations < 6.3 mg/L demonstrated coronary endothelial dysfunction with high specificity both in terms of CBF and CAD response (85%; 88%, respectively). Conclusions: Adiponectin is a better predictor of coronary endothelial function than other factors such as HOMA-R, body mass index, immunoreactive insulin, and triglycerides. (c) 2007 Elsevier Ireland Ltd. All rights reserved.