The median HbA1c levels achieved in the intensive and standard arms were 6.3% and 7.0%, respectively. Intensive treatment produced a relative reduction of 10% ..... very late ST occurs at a relatively constant rate over time up to at least 5 years af
miologic association between glycemia and coronary heart disease (CHD) is sur- prisingly weak. This paradox is a focus of the current review, which also evaluates other major determinants of coronary ar- tery disease (CAD) in type 1 diabetes, in- clu
RESEARCH DESIGN AND METHODS â We investigated the relationship between. IMT and coronary artery disease (CAD) in 40 type 2 diabetic patients and 40 control subjects. Diabetic patients with CAD determined by coronary angiography were consecutively r
revascularization in stable CAD? ... CABG patients have less angina @ 5y: 67% vs. ... Optimal Medical Therapy with or without PCI for stable Coronary disease.
risk of future cardiovascular disease events.1,2 This observa- ... BackgroundâNonobstructive coronary plaques manifesting high-risk morphology (HRM) ...
and independent arbiter of clinical risk.1 In current practice ... From the Section of Noninvasive Cardiovascular Imaging (E.W., S.A.A., B.H., .... CV/i General Electric Healthcare, Milwaukee, WI) with a 4- or ..... both death (13.8% versus 20.3%) an
Angiographic definition of chronic total occlusion (CTO) was used: complete ..... fractional flow reserve computed from coronary CT angiography com- pared to ...
Nov 10, 2016 - pulmonary embolus. â pneumothorax. â pneumonia. â pleuritis .... â¢Sinus tach â Try carotid sinus massage. â¢Atrial flutter â can use adenosine to ...
Albiglutide, a long lasting glucagon-like peptide-1 analog, protects the rat heart against isch- emia/reperfusion injury: evidence for improving cardiac metabolic ...
stali na CABG, mogla bi se ponuditi dijagnostiÃka koro- ...... New answers to three questions on the epidemic of coronary mortality in south Asians: incidence or ...
... Hopkins GeneSTAR Research Program, Department of Medicine (B.G.K., L.C.B., D.V., L.R.Y., ...... McCollough CH, Ulzheimer S, Halliburton SS, Shanneik K, White RD, ... phy angiography as a screening tool for the detection of occult coro-.
Patients with prior. PCI were not excluded. The final study group consisted of 1848 pa- tients (Figure 1). After PCI, we determined the first follow-up procedure as ...
Nov 12, 2017 - (GTVolume, GyroTools LLC, Zurich, Switzerland). For determina- ..... B, Marx N, Paetsch I. Gender-based prognostic value of pharmacological ... Steel K, Broderick R, Gandla V, Larose E, Resnic F, Jerosch-Herold. M, Brown ...
Nov 6, 2017 - pressure gradient is dependent on the hyperemic response ... Key Words: coronary angiography â¼ coronary artery disease .... This concept relies on 2 assumptions. First ... Parametric hyperemic MBF polar maps were visually.
algorithm; periodic repeat CCTAs are defined as Inappropriate .... condition (eg, aortitis or Kawasaki disease) at the time of CT. For these .... Atypical chest pain.
Nov 5, 2017 - ConclusionsâA high BMI was associated with a greater plaque burden; however, a larger external elastic membrane preserved lumen ...
Nov 5, 2017 - Isidre Vilacosta, MD, PhD; IvÃ¡n NÃºÃ±ez-Gil, MD, PhD; Carlos Macaya, MD ..... OÂ´Gara PT, Kushner FG, Ascheim DD, Casey DE Jr, Chung MK, de.
Nov 11, 2017 - nary intervention (PCI) or coronary artery bypass grafting surgery, an ... were the positive, forward-directed (aorta-derived) compression wave.
Circulation 68, No. 5, 986-997, 1983. BECAUSE OF PROBLEMS in the study of the natural history of coronary disease, many ofwhich are insur- mountable, no ...
Apr 5, 2017 - Nevertheless because nonobstructive CAD is a heterogeneous and prevalent condition, there is the need for tools to quantify total coronary.
Apr 4, 2017 - assessing the presence or extent of obstructive coronary stenosis .... tient had not been evaluated for CAD, had >1 clinical cardiovascular.
mg. kg'. h' and were 11.8Â±0.5 (INR=1.0), 12.3Â±0.7 (INR=1.1), 13.3Â±+1.2 (INR=1.4), 14.2+0.4 ... KEY WORDs * .... solution at 30 mL/h. ... Therefore, 200 ,uL of the thrombin solution ..... bin, through point mutations in amino acid position 47,.
From the Division of Cardiology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California. Dr. .... ultrasound ... production was also shown to be associated with lower rates ...... Oriji GK, Keiser HR.
These findings suggest that aneurysmal coronary disease does not repre- sent a distinct ... significant coronary artery obstruction were defined as either a 70% ...
Endocrinology and Thyroid Research ISSN: 2573-2188
J Endocrinol Thyroid Res
Volume 1 Issue 1 - February 2017 DOI: 10.19080/JETR.2017.01.555553
Adiponectin, Diabetes and Coronary Artery Disease Dhastagir Sheriff* Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research, Tamil Nadu, India
Submission: February 10, 2017; Published: February 27, 2017
*Corresponding author: Dhastagir Sheriff, Institute of Medical Sciences and Research, Melmaruvathur, Tamil Nadu, India, Email:
Perspective White adipose tissue is an active endocrine gland communicates with the brain and the peripheral tissue including pancreatic beta cell through adipocytokines . Examples of adipokines are; acylation stimulating protein (ASP), adiponectin, adipsin, angiotensinogen, bone morphogenic protein (BMP), estrogen, insulin-like growth factor-1 (IGF-1), various IGF binding proteins, interleukins (ILs), leptin, monocyte chemoattractant protein 1 (MCP-1), plasminogen activator I (PAI-1), resistin, TNF-alpha, transforming growth factorbeta (TGF-beta) and various prostaglandins [2-8] (Figure 1).
Figure 1: Adipokines and Body Processes.
Adipokines influence many physiological and metabolic processes, such as lipid metabolism, haemostasis, appetite and energy balance, immunity, insulin sensitivity, angiogenesis, inflammation and blood pressure regulation. Adiponectin and leptin are the most studied adipocytokines. Over 90% of adipokines are reported to be produced by the stromal-vascular cells. Different regions of white adipose tissue seem to secrete different adipokines [9,10]. For example, subcutaneous fat depot is reported to secrete leptin and visceral adipose tissue IL-6. Secretory products of visceral adipose tissue are reported to be six adipokines, three chemokines (growth-related oncogen factor, RANTES, macrophage inflammatory protein-1), one interleukin (IL-7), one tissue inhibitor of metalloproteinases (TIMP-1), and one growth factor (thrombopoietin) It is also suggested J Endocrinol Thyroid Res 1(1): JETR.MS.ID.555553 (2017)
that size of the adipocytes influence adipokine secretion. Hypertrophied adipocytes in obesity secrete less adiponectin and more in lean subjects with small sized adipocytes . This could form the basis for the association of adipocyte size to obesity-related complications, such as insulin resistance and the increased risk for coronary heart disease  (Figure 2).
Figure 2: The Major functions of white Adipose Tissue.
Figure 3: Different Forms of Adiponectin.
Of the major adipokines Adiponectin (APN) has a molecular weight of 30-kDA .It exists in many different forms. APN exists as a trimer, known as low molecular weight oligomers, a hexamer, 001
Journal of Endocrinology and Thyroid Research which consist of two trimers linked by a disulphide bond known as middle-molecular weight adiponectin, and a high molecular weight (HMW) multimer [14-17]. The relative distribution of adiponectin multimers seems to differ between the adipose tissue and the circulation. The larger HMW forms is dominating in plasma,  whereas the presence of the globular fragment in human plasma has been questioned [6,7] (Figure 3). APN is considered to be an important modulator of insulin sensitivity  and dyslipidemia . AP is reported to be an anti-inflammatory marker which is shown to have an inverse relation with proinflammatory markers like fibrinogen, intracellular adhesion molecule-1, Eselectin, and C-reactive protein [10,11]. APN though structurally related to TNFα, increases insulin sensitivity particularly in the liver, promotes beta cell function and survival . AP is shown to bind with its receptors in beta cells and may augment glucose induced insulin secretion . It is considered to be a powerful anti-apoptotic molecule possibly through the activation of kinases which promote beta cell survival along with reducing the levels of ceramide and increasing the sphingosine1-phosphate, one of the key anti- apoptotic metabolite . APN is also reported to have a protective effect on coronary artery disease (CAD) evidenced by prospective studies indicating that higher adiponectin is associated with a decreased risk CAD in non diabetic subjects  type I diabetic subjects , type 2 diabetic men  and in end-stage renal disease patients . APN appears to play an important role in the pathogenesis of type 2 diabetes. T2DM patients are reported to have reduced serum levels of APN compared to control subjects [19-21]. It is also observed that higher APN levels are associated with better lipid and glycemiccontrol inT2DM subjects [22,23]. Therefore it is assumed that APN could be a marker of insulin resistance and T2DM . Adiponectin is widely regarded as an anti-atherogenic, antioxidant and anti-inflammatory molecule. However, adiponectin concentration is paradoxically increased in individuals with type 1 diabetes, in whom it is positively associated with adverse clinical outcomes . There is now considerable body of evidence to suggest that there is link between visceral fat and CHD. That is why these molecules are collectively named as ‘adipocytokines.’ It is also known that ‘visceral fat syndrome’ may cause dysregulation of adipocytokines and clustering of other factors. A direct link has been established between visceral fat and CHD. It was named collectively as adipocyte-derived molecules as ‘adipocytokines’. The ‘visceral fat syndrome’ accelerates atherosclerosis due to the dysregulation of adipocytokines and clustering of other coronary risk factors . Circulating adiponectin is shown to accumulate where endothelial barrier is damaged, and has protective effects against almost the whole process of atherosclerosis .Therefore adiponectin and other adipokines do play a vital role in the metabolic processes of the body. APN’s role in insulin action and insulin sensitivity needs more studies to bring out the beneficial effects of APN and its associated adipokines. 002
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How to cite this article: Dhastagir S. Adiponectin, Diabetes and Coronary Artery Disease. J Endocrinol Thyroid Res. 2017; 1(1): 555553. DOI: 10.19080/ JETR.2017.01.555553
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