Sensitivity of Biomarker: Leptin, Adiponectin or High Sensitivity C-reactive protein in diagnosis of Coronary Heart Disease

Background: Adipose tissue is known to produce and release numerous bioactive
substances, known as adipokines (such as leptin and adiponectin), which have been
found to be involved in various physiological processes, including the regulation of
arterial tone. Also, high sensitivity C-reactive protein (hs-CRP) is related to
cardiovascular risk factors and adipokines. Methods: Forty patients with established
coronary heart disease (CHD) defined as old myocardial infarction & angina
pectoris classified as CHD group and ten normal healthy subjects classified as the
control group participated in the present study. All patients and controls were
subjected to complete clinical history taking, clinical examination including 12 lead
electrocardiogram (ECG), diagnostic coronary angiography (CA) and the
measurement of serum levels of triacylglycerols (TGs), total cholesterol (total-C),
low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol
(HDL-C), leptin, adiponectin and hs-CRP. Results: Serum levels of leptin, hs-CRP,
LDL-C and total-C showed highly significant (p< 0.0001) increase, while,
adiponectin levels showed highly significant (p< 0.0001) decrease in the group of
patients when compared to the levels of the control group. The levels of HDL-C in
the group of patients were significantly (p< 0.05) lower than in the control group.
There was no significant difference between the levels of TGs in the patients versus
the controls. Leptin was weakly correlated positively with hs-CRP, while, nonsignificantly
correlated negatively with adiponectin. Hs-CRP was moderately
correlated negatively with total-C. The overall positive rates obtained from Receiver
operating characteristic (ROC) curve for evolution of sensitivity and specificity of
the different biomarkers is obtained. The sensitivity was 100% for both leptin and
adiponectin, but, it was 75% for hs-CRP. ROC curve results revealed that the
specificity for leptin, adiponectin and hs-CRP were 100%, 90% and 80%,
respectively. Conclusion: The results obtained in the present study reveals that
serum leptin, adiponectin and hs-CRP might play an important role in the
pathogenesis of CHD and the circulating levels of leptin and adiponectin provide
highly sensitive and specific biomarkers for CHD more than hs-CRP.