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� � ����������Vol. 33, pp. 111�117, 2005
���������� ������������� Adiponectin �������
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� �)�*+,-�./0��123 adiponectin 456789:�;0<=>?@3AB4C�DE12?@34% F�/G��H'I �PCI� 0JKL<=M�-,NMO@& PQR�M% 56789:ST�UVNW3F�/G��H'I �PCI� S�XYNW3 PCI Z![�7\]^_0`L3 adiponectinSa�bcd>e& `f: g\/ PCIbZ!>�7\G��h< �CAG� b!Oie56789:�26��bjkl�15��B�mcd>e& CAG Z!no0% 6p adiponectin% 6p)q�rstuvwxy% HDL stuvwxy% LDL stuvwxy% p7)��bz{>e& |}: ]^_ ��7\ CAG 0~@? �Diameter Stenosis50����M% 26�p 5��19.2��N �e& PCIZ!�S:"!�% PCIT�o[NSG��"#H�% T�U�~��6p)qM]^_S$%NM�b �O,ie& >,>% ]^_lM]^_SO@l~��jkl��$�0 adiponectin 4��NWie �3.91�0.55 versus7.68�3.60 versus 9.27�2.85 mg�ml; p0.05�& |&: PCI [S]^_'z0�7\6p adipo-nectin z{M$(NWie&
����1� 56789:% 2� uv��% 3� G��H'I% 4� adiponectin% 5� metabolic syndrome
��
C�)N�����0W356789:M%Framingham study ���*,-DE12?@3G������+"% �)6;% �6�% ��% ,-O��S��>e�.S/074DE12?@31�&ASe�% Matsuzawa -2�M� )�¡¢% £�1.k% �)6;% �6�4¤2>e¥�b� )�
;¦lB>?% Reaven3�M§�u��¨©7bª3B>e£�1.k% �6�% �p7)�6;% �HDL �high-density lipoprotein� stuvwxy6;% �§�u��6;O�S¤2>e¥�b meta-bolic syndrome X B>?% Kaplan -4�M£�1.k% �p7)�6;% �6�% �4«,-S 4¬S����45>e"�b®S¯¤°B>?% G����¤2S��7bDE>?±e& ²CA2-4³´>?§�u��¨©7µ,-b$>?@3AB,-% WHO �World Health Organization�5� ~��NCEP-ATPIII �National Cholesterol EducationProgram-Adult Treatment Panel III�6� �� meta-
1 ��������¶6·¸7"¹ ���º»¼���2 �������� ���º»¼���
111
23
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*��()���!��+"��*�
�����
�� ���� ����'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$�T� B���@43ATJ,��BU ¡�¢,B��£V�1¤M��WX�Y��*x:�)���¥ST����
� � �
��,Z¦�[�\§�]�� 2¨���©^,Mann-Whitney U ©Ga�� c2-©G �Fisher[s ex-act probability test�� _¨���©^, Fisher’sProtected Least Significant Di#erence���`E£a�T� p0.05��{��*�
� �
�� ���� �Table. 1�)s�Pr*-+��./x:�(�U CAG ��VCD��b)(� �1� VCD�1¤P)r*¨�No restenosis ¨, 21 :�� �2� VCD�1¤*¨�Restenosis ¨� 5:�� �3� )�¨ �Control ¨� 15:� ��R�*�No restenosis ¨� Restenosis ¨����c� �
d� B�����ª+�� ef � ª +x� «¬�� �® �¯°� ±²³´�F�§,1¤P)r*��� �� !"#$�� 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$��§,1¤P)r*�
ijkl ¼�mn (112
24
Table 1. Clinical Characteristics of the PCI and Control Groups
Table 2. Angiographic Lesion Characteristics
PCI �������� Adiponectin � 113
25
��� CAG ������ RD ���� �� MLD ��� �DS ���������� �p�0.05���� ����������� adiponectin� �� �Table. 3�
3��������������� !� HDL����� !� LDL ����� !� ����������� �� �� adiponectin Res-
tenosis ���"#�$�����%� �p�0.05��
� �
�&'�()�*+,-./#� � �� 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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���� ���� 116
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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.
PCI �������� Adiponectin � 117
29