Adiponectin is inversely related to plasminogen activator inhibitor type I in patients with stable exertional angina

Adipose tissue is a secretory organ producing a variety of bioactive substances, such as adiponectin. Adiponectin has antiatherogenic properties while plasminogen activator inhibitor type I (PAI-I) is closely involved in the development of atherosclerosis. The relationship between adiponectin and PAI-I in patients with coronary artery disease (CAD) has not been clarified. This study examined plasma levels of adiponectin and PAI-I in 64 patients with stable exertional angina (SEA) and 65 patients with the chest pain syndrome (CPS). Plasma log- adiponectin levels were significantly lower in patients with SEA (0.62 +/- 0.08 mug/dL) compared to those with CPS (0.86 +/- 0.05 mug/dL) (p < 0.0001). The plasma levels of log-PAI-I were significantly higher in patients with SEA (1.23 +/- 0.18 ng/mL) compared to those with CPS (1.15 +/- 0.22 ng/mL) (p < 0.05). Plasma log-adiponectin levels correlated negatively with diabetes mellitus (DM), body mass index (BMI), log-PAI-I (r = -0.284, p < 0.001), triglyceride (TG), and remnant-like particles cholesterol (RLP-C), and positively with high-density lipoprotein cholesterol (HDL-C) levels. Plasma levels of log-PAI-I correlated positively with DM, BMI,TG and RLP-C levels, and negatively with HDL-C levels. Multiple logistic regression analysis identified sex, angina pectoris, and PAI-I as independent determinants of hyperadiponectinemia (p < 0.05). Adiponectin is inversely related to PAI-I. DM, BMI,TG, HDL-C, and RLP-C are common mediators between adiponectin and PAI-I, and treatment for common mediators may prevent the development of CAD by reducing PAI-I and increasing adiponectin levels.