˘ˇˆ adiponectin - marianna uigakukai.marianna-u.ac.jp/idaishi/www/332/04-33-2tomoyuki...

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臙腨腩腡腭腧腲腺自膀膮膺 Vol. 33, pp. 111117, 2005 腉腘腕腅腗腚腈腒腐腌腃腍腇腎腜腓腄腏腂腀腁 腙腑腆腊腔 Adiponectin 腃腛腝腑腃腋腖 腊腖 腏腜 腕腟 腢腈 1 腡腜 腅腒 腜腎 腙腤 1 腇腝 腑腄 2 腃腆 腡腉 腙腔 2 腌腥 腍腅 腋腥 2 腓腒 腇腓 腙腌 2 腕腏 2 腘腏 腟腕 腗腛 腢腈 2 腏腠 腘腣 1 腡腋 腚腝 腙腌 2 : 17 3 16 臞臒腄腜腱臷腓腚腏腈腟腞 adiponectin 腅膍膚臖臔膾膂臌腓腵膑腉腎腂腞腇腐腅膒 膶臶腈腟腎腂腞腅臷膁腀腣膖臗臇 PCI腓膌腗腊腵膑腕腜腄腏腕腒腂膨腽腼膍膚臖臔膾膂腔膽臁臭腏腁腞膘臷膁腀腣膖臗臇 PCI臫臸腏腁腞 PCI 膷膤膠臖膉膫膐膭腓臦腊腞 adiponectin 腔膅腠膝臼腉腋臦臍: 臨膉臷 PCI 腠膷膤腉臖膉膁腀腣 臤腵 CAG腠膤腒腌腋膍膚臖臔膾膂26 腠膜臐膔15 腾膝臼腉腋CAG 膷膤臱臝 膚臰 adiponectin膚臰膹膿臡腣腫腤腥腬腀腪HDL 腣腫腤腥腬腀腪LDL 腣腫腤腥 腬腀腪臰臖膹腠臥致腉腋膙腻: 膫膐膭 臖膉 CAG 腓腃腂腎 Diameter Stenosis 50腯臎26 5 19.2ῒ῏腘腋PCI 膷膤膼腔膂臀PCI 臝膠腏腔膁腣腔腝膖臩臁膊腃腛腖膚臰膹膿腕膫膐膭腔腪腤腏腕膪腠腘腒腄腌腋腉腄腉膫膐膭 膔腕膫膐膭腔腒腂膔腃腛腖膜臐膔腛腝腰腓 adiponectin 腅至臮腏腁腌腋 3.910.55 versus 7.683.60 versus 9.272.85 mgml; p0.05: PCI 膠腔膫膐膭臥腓臖膉膚臰 adipo- nectin 臥致腕腪腮腏腁腌腋腇腄腊腆 1膍膚臖臔膾膂2腤腥腭腦3腀腣膖臗臇4adiponectin5metabolic syndrome 腂腀腃腁 腆腠腞腏腙臢腹膕膢腓腁腞膍膚臖臔膾膂腕Framingham study 腛腝臅腄腜膶臶腈腟腎腂腞膁 膆膟腳膳腄腔膥膹膚臌膥膚腮膋腶腑腢 腒腑腔臠臏腉腋膄腓腯臖腅膶臶腈腟腎腂腞 1腇腔腋腘Matsuzawa 2臣膹臯臜臧臻腱臐膥膹膚臌膥膚腮腅臆腉腋臑臩腠臣膹臌膡膔腐腉腎Reaven 3腕腢腭腤腩腭臵膣臖腠膈腐腉腋臧臻腱臐膥膚腮膥臰臖膹膚臌HDL high-density lipoprotein腣腫腤腥腬腀腪膚 膥腢腭腤腩腭膚臌腒腑腔臆腉腋臑臩腠 meta- bolic syndrome X 腐腉腎Kaplan 4腕臧臻膥臰臖膹膚臌膥膚腮腑腢4 腍腔 膆膟腳膳腅膧腉腋臩腠膸腔膲臆臟腐腉腎膁膆 膟腳膳臆腔膆膟臖腠膶臶腉腎腆腋膬膒腇腟腜腅 膎臲腉腎腢腭腤腩腭臵膣臖腚腑腢腉腎腂腞腇腐 腄腜WHO World Health Organization5腃腛腖 NCEP-ATPIII National Cholesterol Education Program-Adult Treatment Panel III6腛腝 meta- 1 臙腨腩腡腭腧腲腺自膀腷膴臚腘腔腺膀臊膃膇 2 臙腨腩腡腭腧腲腺自膀 腺膀臊膃膇111 23

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����1� 56789:% 2� uv��% 3� G��H'I% 4� adiponectin% 5� metabolic syndrome

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;¦lB>?% Reaven3�M§�u��¨©7bª3B>e£�1.k% �6�% �p7)�6;% �HDL �high-density lipoprotein� stuvwxy6;% �§�u��6;O�S¤2>e¥�b meta-bolic syndrome X B>?% Kaplan -4�M£�1.k% �p7)�6;% �6�% �4«,-S 4¬S����4­5>e"�b®S¯¤°B>?% G����¤2S��7bDE>?±e& ²CA2-4³´>?§�u��¨©7µ,-b$>?@3AB,-% WHO �World Health Organization�5� ~��NCEP-ATPIII �National Cholesterol EducationProgram-Adult Treatment Panel III�6� �� meta-

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111

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bolic syndrome ���������������� ����������������

�� ���� ���� �adipocytokine� �������������� �!��"��� !�metabolic syndrome ��#$%�&���� adi-pocytokine� 1'� � adiponectin������()��*7�� +� adiponectin ,-+��./����� �!�8�9�� ��01��2��3&4�4�567�56+8��9�����!�)(+856:�;<�=>���10���)�� 2��3&4�4�?*,@43A���B��CD !�EF"�G#56�H!�I�B��J$�%�K�"B��L&M �PCI: per-cutaneous coronary intervention� �+� adipo-

nectin�NO,�()�,P� 'QR,� PCIST7(�UVCD�)��+� adiponectin �N*��()���!��+"��*�

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�� ���� ����'W1, 2002� 7X)(,� 9X�-%YZ3[\].$ ^ �]�_`���a�� '.$�/0 bcde1�2 586f���gh� I3�i4��j��5��T� i4�k3lm�nop3q3A�%*6�Tr*��� ��)s,� 7U" PCI �ST�� t8 3�6uX7�(�Uv1B��9; �CAG: coronary angi-ography� �Tw*-+��./x: 26 :�;�18:� y� 7:: 65.7�9.7z��)s��*� ?*<i��,{�%(*|=}~34�Z�;� 15:: 37.7�14.3z��)���*��� ����(�U CAG ST>3��+�T� +� adi-

ponectin �adiponectin enzyme-linked immuno-

sorbent assay kit, .?@A�@� B'� a��+� ���CD��� Ep�@4���� HDL p�@4���� LDL �low-density lipoprotein� p�@4���� �� ���FG�*�CAG ��,GH"B��9; �QCA: quantita-

tive coronary angiography� IJ �CMS �@� Z�Y&� ���� Reference Diameter �RD�, LesionLength�LL�, Minimum Lesion Diameter �MLD�,�Diameter Stenosis ��DS� �EF�*� QCA E

F,'QR����K(��P_`�LM\��r�Tw*� �� (�U CAG ���DS 50��6�VCD�G��*��� B�������� �88 ,� B'���#$d����#�./�8�ko~k3 2002�NO��r*�

PCI ��

PCI ���PQ��2��3&4�4�a��@43A��R� 2��3J$�a��J$������,M���S����� �'"P PCI ��, balloon�vessel ratio 1.11.2��2��3&4�4��j��J$�T� B���@43ATJ,��BU ¡�¢,B��£V�1¤M��WX�Y��*x:�)���¥ST����

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��,Z¦�[�\§�]�� 2¨���©^,Mann-Whitney U ©Ga�� c2-©G �Fisher[s ex-act probability test�� _¨���©^, Fisher’sProtected Least Significant Di#erence���`E£a�T� p0.05��{��*�

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�� ���� �Table. 1�)s�Pr*-+��./x:�(�U CAG ��VCD��b)(� �1� VCD�1¤P)r*¨�No restenosis ¨, 21 :�� �2� VCD�1¤*¨�Restenosis ¨� 5:�� �3� )�¨ �Control ¨� 15:� ��R�*�No restenosis ¨� Restenosis ¨����c� �

d� B�����ª+�� ef � ª +x� «¬�� �­® �¯°� ±²³´�F�§,1¤P)r*��� �� !"#$�� PCI ��%&'(�Table. 2�

No restenosis ¨� Restenosis ¨���� )s+8�gµ� B�� !¶xN�R� PCI �¯°�§,P)r*�PCI ST37�� !Lh�N��� M3�

RD, LL, MLD, �DS a��M7 RD, MLD, �DS �§,1¤·� B���@43ASTx:�a�,¸��*@43A¹kºa��».J$��§,1¤P)r*�

ijkl ¼�mn (112

24

Table 1. Clinical Characteristics of the PCI and Control Groups

Table 2. Angiographic Lesion Characteristics

PCI �������� Adiponectin � 113

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��� CAG ������ RD ���� �� MLD ��� �DS ���������� �p�0.05���� ����������� adiponectin� �� �Table. 3�

3��������������� !� HDL����� !� LDL ����� !� ����������� �� �� adiponectin Res-

tenosis ���"#�$�����%� �p�0.05��

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�&'�()�*+,-./#� � �� 0��1� 0�2� 345�6789� ��:;<=�>��0 LDL �1����?@8A�BCDEF��" LDL �G����H.I9#"J�K��LHM�N�O��%P11�� Q *+,-��R���.I9#S �T��U()��VJ)W���XY�Z��

8� �A/:0����� !�1�[\?�/#"J.]8A� ^*+,-� 3�4_�VJ��#T��U()��1*+�� 10.56�.0\J`.� 8�.� 12�� ab`�`.^*+,-�c!�\ metabolic syndrome ./#Q =�>"d.#$I9#"J�� WHO 5� .NCEP-ATPIII6� �e%fghP� �N&iI9#""�Metabolic syndrome ��"#'j(�)�*kl����+mVJ(,���c��%P 2�� nopqrs�tu>o�#no��vw�-h���aVJ apM1 �adipose most abundant gene tran-script 1�13� x.-y/./# adiponectin ��zI

9 � adiponectin {|no��� 7�12 mg�ml0b/� 1(2�"`.� }3�#4~� (,��+m.5"}�VJ`.� 8��I9#"J 9�14���� adiponectin T��U()��"#���V`.8�9�� �&'��6�%J�7,-�a��L/��(8�9��:��7�;�8�� �>��� t� Class A Scavenger receptor mRNA �a��L/� �>��� t�<='��L15�� I8���>���9�4��?@�L��16�� 8��I9 � I8� adiponectin �A���������#(*B��[\�a/� `�B�� adi-ponectin C��#�LI9J`.�817�� ^����2������D��/#^��EI�JPCI ������� VJc�� ¡ .�P¢J.£¤89 � /�/ Shimada 818�� 127 F���Do¥� PCI 1F��Z��� PCI ������ adiponectin PCI�GHI� 1¦�%J���§���JK,-.PL�� ����§���¨,� 1 ¦./#� PCI ��J

�����©ª./ ��>���9��«?@�4��£¤89#"J� ¬�­M�U1)W�"d./ ��Do��" PCI ��"#� "d�.N®/# cilostazolO���#��� MLD ����PS"¯�P��>��4����� .°±�Q� ²M cilostazol ���>��4��LHM�����R³/#"J19��´µ¬�� Shimada 818��Z��S¶¤ PCI��·�¸¹J�����6T� ��>����«4��?@�6T5�8��� CAG ¶��U����� adiponectin �2VJºV��»@9 `.�8� WZ���� �

Table 3. Metabolic Variables of the PCI and Control Groups

XYZ[ ¼({\ 8114

26

��� ���������� ��������� ���� ����� ������ !"#$%&��$'(()�*� Restenosis+$�,���- adiponectin./012� No restenosis+��- adiponectin 3456789$�/012:;6(�� ������- adiponectin ./&PCI <=>?��@"#6ABC�;6&1DE�:���(�FGE�����- adiponectin &H��IJK$,��./�L�;68�9�� Shimada �18�

�M���- adiponectin (�������&N���;6� E�$ PCI <$,��'���=>?OP��Q&L�;6(�19�20�� M��(����RS�TU��- adiponectin ./VWX:./RYZ2:[\�� �- adiponectin ]^(�PCI $_��`abc9$,d��`efghi�jk��l�mn��op&q;B16�17�=>?�r&sAE�tu�vw6�x:;6&yzE�:��{|}��~�"#���L� adiponectin ����$�u���������62�����*� PCI <=>?�F������62���u����&1DE�:� 2(2�&�� ���<������LB� X:W����;6� �������L�;6� ��E������� ¡��21� � ;�X�$FGE��E���� C-reactive protein¢£�=>?�@"#6��¤22������&Z¥�,�*� ¦<���§¨6©¥��:�ª� ��«��¬� ­ 67®¯�°±²³´³

µ¶´·´�2003¸ 3¹� º»�$��¼2:�

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Abstract

The Plasma Level of Adiponectin During the Chronic Stage is a

Predictor of Re-stenosis after Percutaneous Coronary Intervention �PCI�.

Tomoyuki Kunishima1, Masahiro Yamauchi1, Taishi Mikami2, Hideshi Aoyagi2,

Ken Kongoji2, Katsuhiko Tsuchiya2, Toshio Sasaki2, Nobuyuki Hashimoto2,

Haruki Musha1, and Fumihiko Miyake2

Background: From recent studies, adiponectin, an adipocyte-specific plasma protein, has been ob-

served to influence ischemic heart disease. However, measurement of adiponectin before PCI could not

predict restenosis. Thus, we assessed the hypothesis that measurement of adiponectin during the chronic

stage may predict restenosis after PCI.

Method: The subjects consisted of 26 patients who underwent elective PCI, and the control of 15

healthy-men. The plasma levels of adiponectin, total cholesterol �TC�, LDL-cholesterol �LDL-C�, andtriglyceride �TG� were measured on the follow-up coronary angiography �CAG�. Restenosis was defined asmore than 50� stenosis in the follow-up CAG. The results were expressed as mean ��� SD.Results: Restenosis occurred in 5 �19.2�� of 26 patients. There were no di#erences in the clinical

characteristics of the patients, coronary artery morphology or PCI technique between the restenosis and

no-restenosis groups. The plasma level of adiponectin was significantly lower in the restenosis group than in

the no-restenosis and control group �3.91���0.55 versus 7.68���3.60, 9.27���2.85 mg�ml, p�0.05�. TheTC, LDL-C and TG were not significant in any of the groups.

Conclusion: The plasma level of adiponectin during the chronic stage was a good predictor of restenosis

after PCI.

1 Department of Cardiology, St. Marianna University School of Medicine, Yokohama-City Seibu Hospital,

Yokohama, Japan.

2 Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine,

Kawasaki, Japan.

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