ASSOCIATION OF ADIPONECTIN WITH GLYCOSYLATED HEMOGLOBIN IN DIABETICS WITH AND WITHOUT CORONARY HEART DISEASE

Abstract

This is a cross-sectional and analytical study. The study population consisted of three groups; A, B and C. Group A comprised of healthy controls, group B comprised of type 2 diabetic patients and group C comprised of type 2 diabetic patients having coronary heart disease (CHD). Each group contained 60 members. The participants of the study were selected randomly from referral tertiary care hospitals of Peshawar including Khyber Teaching Hospital (KTH), Hayatabad Medical Complex (HMC), Lady Reading Hospital, Peshawar (LRH) and Rehman Medical Institute (RMI). A questionnaire was used to record participant history. Fasting samples of blood were collected from all participants. Biochemical analysis was done for fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), very low density lipoprotein cholesterol (VLDL-C) and serum adiponectin levels. The biochemical analysis was carried out in the research laboratory, Department of Biochemistry, Khyber Medical College. SPSS version 19 was used for the analysis of the data. In this study, higher levels of adiponectin were recorded in women than men; significant difference was seen in the control group. Significantly higher concentrations of HbA1c, FBG, TC and TG (p value <0.05), were noted in diabetic participants and those having diabetes with coronary heart disease. Both the diseased groups presented with significantly low serum adiponectin (p<0.001) and HDL-C (p<0.001) concentrations than the control. Participants having type 2 diabetes mellitus with and without CHD did not show any significant difference for the studied variables. iThe association of serum adiponectin with other parameters was determined. Adiponectin level was positively associated with HDL-C in control (male: r 0.948; p=<0.01, female: r 0.988; p=<0.01), type 2 diabetic participants (male: r 0.860; p=<0.01; female: r 0.908; p=<0.01) and type 2 diabetic participants having CHD (male: r 0.650; p=<0.01, female: r 0.775; p=<0.01). Significant negative association of adiponectin level was observed with TG in control (male: r - 0.537; p= <0.01; female: r -0.515; p=0.01), type 2 diabetic participants (male: r -0.747; p =<0.01, female: r -0.790; p=<0.01) and type 2 diabetic participants with CHD (male: r -0.640; p=<0.01, female: r -0.669; p=<0.01). In both the diseased groups, level of adiponectin in the serum was negatively associated with FBG and HbA1c with p value<0.01. The negative association of adiponectin with FBG was slightly weaker in male diabetic patients having CHD with p value 0.04. Type 2 diabetic subjects showed negative association of adiponectin with TC and LDL-C (each with p value<0.01). Type 2 diabetic subjects having CHD showed a weak negative association of adiponectin with TC in female participants with p value 0.03. Control male participants showed negative association with LDL-C in male members (p=0.002). This study concludes that adiponectin level is markedly decreased in type 2 diabetes mellitus, with and without CHD. The adiponectin level showed positive association with HDL-C and negative association with HbA1c and TG. Therefore, adiponectin level acts as a biomarker of glycemic status and lipid profile in type 2 diabetes mellitus alone and with coronary heart disease.