Association of biomolecules of secretory activity of visceral adipocytes with long-term results of myocardial revascularization in men with coronary atherosclerosison the background of metabolic syndrome

Abstract

Aim. The udy in coronary atherosclerosis (CA) and metabolic syndrome (MS) of blood biomolecules associated with secretory activity of visceral adipocytes, and the search for their associations with long-term 5-year results of coronary artery bypass grafting (CABG). Material and methods. The study included 123 men 41-79 years with a CA, verified coronary angiography and with stable angina pectoris. Components and signs of MS were evaluated: waist circumference (ОТ), arterial pressure (SBP, DBP), blood lipids and glucose levels. In blood, the levels of biomolecules associated with the secretory activity of visceral adipocytes (tumor necrosis factor alpha, TNF-alpha, interleukin 6, IT-6, leptin, resistin, adiponectin) were determined by blood enzyme immunoassay. The results of a 5-year course of CA after surgical myocardial revascularisation were obtained and 4 groups of men with complicated CA flow were identified (myocardial infarction, MI, cardiovascular death, CVD, repeated surgical myocardial revascularisation, unfavorable long-term period in general). Results. MS as a whole in the group was revealed in 86 men (69.9%) with abdominal obesity and CA. The level of TNF-alpha, was elevated in 47.2% of men, the level of IT-6 in 72.4%, the level of hBCR in 64.2%, the level of leptin in 47%, the level of resistin 54%, the level of adiponectin was reduced in 22% of cases. In men in the 5-year distant period with developed MI, with a repeated operation and with an unfavorable long-term period in general (MI and/ or CVD and/ or reoperation), the level of blood leptin was 2.8 times higher before the operation of the CABG (p < 0.0001), 1.8-fold (p < 0.05), and 1.6-fold (p < 0.05), respectively, compared with persons without complications in the long-term period. In men with CVD cases in the long-term period prior to the CABG operation, the blood levels of TNF-alpha, and resistin were 2.8 times higher and 1.6 times, respectively (p < 0.05), compared to those without CVD in the distant period. Positive correlations (p < 0.05) between the level in the blood of leptin and MI, reoperations and, in general the unfavorable long-term period, as well as between the levels of TNF-alpha, resistin and cases of CVD in the long-term period were found. In multivariate regression analysis, it was found that an elevated blood level of leptin is associated with a relative risk of reoperation in the 5-year period after CABG (OR = 1.261; 95% Cl: 0.994-1.599;p < 0.047) and the relative risk of a generally unfavorable long-term period (OR= 1.265, 95% Cl: 1.016-1.577,p< 0.036). Conclusion. There is an association of elevated leptin levels in the blood with adverse long-term 5-year results of “ myocardial revascularisation in men with coronary atherosclerosis in the background of metabolic syndrome.