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

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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� )�

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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

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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

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��� ���������� ��������� ���� ����� ������ !"#$%&��$'(()�*� 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.

PCI �������� Adiponectin � 117

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