Abnormalities in energy metabolism and endothelial dysfunction contribute to signaling processes associated with atherogenesis. The goal of our study was to develop diagnostic tests based on endothelial functional markers and adiponectin to differentiate early stages of coronary lesions during atherogenesis. The cohort included male and female patients from 25 to 86 years of age. All subjects underwent coronary angiography and severity of coronary lesions was quantified by the Gensini score that assigns points depending on location and extent of the lesions. We have estimated associations between the Gensini score and some known primary and secondary diagnostic parameters and have found that the ratio of serum levels of adiponectin to endothelin strongly correlates with severity of coronary lesions and can be used for differentiation of male patients lacking coronary atherosclerosis (despite symptoms of ischemic heart disease) from patients that have severe coronary lesions. Predictive power of adiponectin to endothelin ratio did not depend on drug therapy.
Narushenie signal'noĭ reguliatsii, initsiiruiushcheĭ aterogenez, pomimo disfunktsii éndoteliia, okhvatyvaet énergeticheskiĭ metabolizm. Tsel' issledovaniia sostoiala v razrabotke diagnosticheskikh testov s uchastiem éndotelial'nykh markerov i adiponektina, kak reguliatorov protsessov, narushenie kotorykh sviazano s aterogenezom, kotorye pozvolili by diskriminirovat' ateroskleroticheskie porazheniia koronarnykh arteriĭ (KA) na rannikh stadiiakh. V issledovanie byli vkliucheny muzhchiny i zhenshchiny v vozraste ot 25 do 86 let, s podozreniem na koronarnuiu bolezn' serdtsa (KBS). Vsem patsientam byla vypolnena koronarnaia angiografiia (KAG) s kolichestvennoĭ otsenkoĭ porazheniia koronarnykh arteriĭ po indeksu Gensini, otrazhaiushchemu stepen' i lokalizatsiiu porazheniia, vyrazhennomu v ballakh. Iz vsekh proanalizirovannykh markerov i ikh kombinatsiĭ, tol'ko kombinirovannyĭ marker adiponektin/éndotelin sposoben sluzhit' novym diagnosticheskim testom khoroshego kachestva dlia stratifikatsii patsientov muzhskogo pola bez porazheniĭ KA, no s klinicheskoĭ kartinoĭ, kharakternoĭ dlia KBS, i nachal'noĭ stepen'iu ateroskleroza KA ot patsientov s bolee vyrazhennymi porazheniiami KA. Prediktornye svoĭstva dannogo testa pokazali éffektivnost' na fone primeniaemoĭ lekarstvennoĭ terapii.
Keywords: adiponectin; atherosclerosis; biomarkers; endothelin; stable metabolites of nitric oxide.