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Chin Med J 2008;121(24):2509-2516
Adiponectin, an adipocyte derived hormone, appears to be a modulator of systemic inflammation, and was found to be decreased in conditions such as T2DM and CAD.7-11 Some authors have observed that sex, BMI and diabetes are the major determinants of serum adiponectin levels.12 Urine albumin excretion rate (UAER) is a marker of endothelial dysfunction, and it has been demonstrated that increased UAER is associated with a higher risk of cardiovascular morbidity and mortality in patients with CAD, DM and even nondiabetic subjects.13-17 The presence of microalbuminuria may represent an early sign of widespread derangement of endothelial function, inducing an atherogenic diathesis.18 In the present study, we examined serum hs-CRP, adiponectin levels and UAER in subjects with angiographically documented CAD in a Chinese population, and further explore the levels of the three markers in these subjects with different glucose tolerance status and the possible association of these markers with CAD risk factors and the severity of CAD as well. METHODS Participants A total of 242 angiographically documented CAD patients recruited during June 2006 to May 2007 from the Department of Cardiology of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine participated in this study. During this period, 1680 patients were recommended to accept selective coronary angiography and 1100 were diagnosed with coronary artery disease. Among the 1100 CAD patients, 102 had T2DM, 40 had impaired glucose tolerance (IGT) and another 100 CAD subjects with normal glucose tolerance (NGT) were selected as controls. Of the 102 diabetic patients, 20 were newly diagnosed as T2DM through 75 g oral glucose tolerance test (OGTT) according to the 1999 World Health Organization criteria,19 and of the 40 IGT patients, 28 were newly diagnosed. The three groups were further named as T2DM + CAD group, IGT + CAD group, and NGT + CAD group, respectively. The T2DM + CAD and NGT + CAD groups were matched for sex, age and BMI. All subjects were Chinese living in Shanghai and its neighboring areas and all gave their informed consents. The Institutional Review Board of Ruijin Hospital approved the study protocol. Oral glucose tolerance test OGTT was performed in all subjects after an overnight fasting of 12 hours. Blood samples were collected before and at 2 hours after a standard oral glucose load of 75 g for the measurement of fasting plasma glucose (FPG), fasting serum insulin (FINS), hemoglobin A1c (HbA1c), triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A (Apo A), apolipoprotein B (Apo B), lipoprotein(a) (Lp(a)), 2-hour

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