Adiponectin-resistin index and its strong association with acute coronary syndrome in South Indian men
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India has the highest burden of acute coronary syndromes worldwide. Apart from certain lipid alterations that have been established to be definite risk factors, low level of adiponectin, high levels of resistin, and IL-6 have been shown to be risk factors for cardiovascular events. Insulin resistance is also a significant predictor of poor outcome in patients admitted with ACS.
69 male patients with ACS and 70 age-matched healthy males were recruited in the study. Insulin, total adiponectin, resistin, and IL-6 levels were assayed in all study subjects. Indices of insulin resistance and novel adipokine indices were calculated using standard formulae. Multiple logistic regression analysis was done to find out the best predictor of ACS.
Resistin, IL-6, insulin resistance indices, AR index, and IRAR index were found to be significantly higher, while insulin sensitivity indices and total adiponectin were found to be lower in cases, as compared with controls (p < 0.001). Insulin resistance was found to be higher in the admission sample, when compared to the fasting sample in patients with ACS (p = 0.01). On multivariate logistic regression analysis, HOMA-IR and AR index were found to be significantly associated with ACS. AR index was the best independent predictor of ACS, with the highest odds ratio (AR index: adjusted OR 17.528, p < 0.0001 versus HOMA-IR: adjusted OR 1.146, p = 0.001).
The present results implicate that adipokines are significantly associated with pathogenesis of ACS, warranting adequate and early appropriate treatment to reverse this metabolic dysregulation. In our study, AR index was the best predictor of ACS. Hence, the novel AR index might be useful in routine clinical practice for screening persons with increased risk of future development of ACS.
KeywordsAcute coronary syndrome Adipokines Insulin resistance
Acute coronary syndrome
Coronary artery disease
Acute myocardial infarction
Tumor necrosis factor-α
Admission insulin resistance index
Fasting insulin resistance index
- AR index
- IRAR index
Insulin resistance index
We wish to thank Mr. Vengattaraman, Technical Assistant and Ms. Durgadevi T, Lab Technician for their help in assaying the study parameters by chemiluminescence and ELISA, respectively. We also thank Dr. Laxmisha Chandrashekar, Associate Professor of Dermatology, JIPMER, Puducherry for helping with the statistical analysis. Financial assistance from JIPMER, Puducherry in the form of Intramural Fund for this research work is gratefully acknowledged.
Conflict of interest
The authors report no conflict of interest related to this work.
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