Hypoadiponectinemia and Hyperuricemia as Risk Factors of Acute Coronary Syndrome in Kerbala Province

Aim: This study aimed to investigate and evaluate the Hypoadiponectinemia and hyperuricemia in acute coronary syndrome (ACS) patients in holy Kerbala city, Iraq.Methods: Case-control study conducted on 58 patients admitted with a diagnosis of ACS and 30 healthy subjects as control group. Measurement of Adiponectin and uric acid, triglyceride, total cholesterol and high-density lipoprotein cholesterol (HDL-C) levels in addition to BMI were measured for all subjects.Results: Adiponectin serum concentrations were significantly lower in persons with ACS compared with healthy control subjects. Uric acid serum concentrations were significantly higher in subjects with ACS compared with healthy control subjects; hyperuricemic patients significantly higher developed heart failure. Conclusions: Hypoadiponectinemia was negatively correlated with hyperuricemia in Patients with ACS. Level of serum adiponectin was significantly lower in patients ACS and level of serum uric acid was significantly higher in patients ACS. *Batool Luay Aziz, **Dr. Shaymaa Zahraw Nada, *** Prof. Dr. Ahmed Hussein AlMayali * , ** , *** Department of Biochemistry (Clinical), College of Medicine, University of Karbala, Holy Karbala city, Iraq. Submission: 2 February 2017 Accepted: 7 February 2017 Published: 25 February 2017 www.ijppr. humanjournals.com Citation: Batool Luay Aziz et al. Ijppr.Human, 2017; Vol. 8 (3): 102-109. 103 INTRODUCTION Acute coronary syndrome (ACS) describes the range of myocardial ischemic states that contain unstable angina, non-ST elevated myocardial infarction (NSTEMI), or ST-elevated myocardial infarction (STEMI). The diagnosis and classification of ACS based on a thorough offer of clinical features, including electrocardiogram (ECG) findings and biochemical markers of myocardial necrosis [1]. Unstable angina is defined by the presence of ischemic symptoms without elevations in biomarkers and passing if any, ECG changes [2]. The term myocardial infarction (MI) used when there is evidence of myocardial necrosis in the setting of acute myocardial ischemia [3]. ACS occur because of the destabilization of atherosclerotic plaques, which may undergo tear or erosion [4]. Adiponectin is an adipocyte-specific protein amply present in the plasma. Since its discovery, numerous experimental and clinical studies have demonstrated that adiponectin has anti-atherogenic, anti-diabetic and anti-inflammatory properties. Hypoadiponectinemia plays a key role in the pathogenesis of metabolic syndrome [5]. Uric acid is the final breakdown product of purine decay in humans [6]. Elevated serum uric acid has proved to be risk factor for ischemic heart disease and other cardiovascular diseases in several epidemiologic studies [7, 8]. It is also linked with increased death from cardiac causes [9]. Experimental studies have shown a uric acid link to endothelial dysfunction [10, 11], impaired oxidative metabolism, platelet adhesiveness and platelet aggregation [12]. MATERIALS AND METHODS Study Group: Consecutive patients were enrolled from inpatients who underwent coronary angiography at Al-Hussein Teaching Hospital, Al-Hussein Medical City from May till August 2016. The control subjects were selected from male and female who visited hospital. Healthy controls were characterized by no history of ACS and another heart disease. Traditional risk factors of ACS like smoking, hypertension, dyslipidemia and family history of premature CAD were excluded. Subjects and experimental protocol: In all participants, clinical history and complete physical examination including measurements of blood pressure and body mass index (BMI) were collected. Obesity was defined as BMI > 30kg/m 2 . Diagnosis of hypertension was based on blood pressure measurement (>135/85mmHg) or antihypertensive medications and it was assessed using information by self-reported history. Diabetes mellitus was defined as fasting plasma glucose ≥126mg/dl or those with history of diabetes and use of anti-diabetic www.ijppr. humanjournals.com Citation: Batool Luay Aziz et al. Ijppr.Human, 2017; Vol. 8 (3): 102-109. 104 medications. Diagnosis of dyslipidemia was based on serum High-density lipoprotein cholesterol (HDL-C) level <40mg/dl for males, HDL-C level <50mg/dl for females and triglycerides level >150mg/dl were considered abnormal. Continuous variables like age, height, weight, BMI and laboratory findings were calculated as mean and standard deviation. T-test and ANOVA were used to see significant relationship of study variables between ACS patient group and healthy control group. All data were entered and analyzed through SPSS. A p-value of 0.05 was considered statistically significant.