IAJPS 2019, 06 (06), 11478-11485 Sidra Nisar et al ISSN 2349-7750

CODEN [USA]: IAJPBB ISSN: 2349-7750

INDO AMERICAN JOURNAL OF

PHARMACEUTICAL SCIENCES
[Link]

Available online at: [Link] Research Article

ASSOCIATION OF HYPOADIPONECTINEMIA TO A COMPLETE

CHOLESTEROL TEST AND GLYCEMIC CONDITION IN FEMALES
WITH TYPE 2 DIABETES IN THE PRESENCE AND ABSENCE OF
CORONARY ARTERY DISEASE (CAD)
1
Dr Sidra Nisar, 2 Dr Ghulam Ali Hasnan, 3 Dr Salman Mahmood
1
Combined Military Hospital, Lahore, 2 Services Institute of Medical Sciences Lahore, 3 Govt THQ
Hospital Raiwind, Lahore.
Article Received: April 2019 Accepted: May 2019 Published: June 2019
Abstract:
Objective: We aimed in this analysis to observe the revolving adiponectin absorption in type 2 diabetic females in
the presence and absence of coronary artery disease (CAD) and to develop an association of adiponectin intensity
complete cholesterol test and glycemic condition of these females.
Study Design: A cross sectional type of investigative analysis.
Place and duration: This analysis was conducted in the Services Hospital, Lahore for the duration of one year from
December 2017 to November 2018. The verification of this analysis was gained from Ethical Committee of Services
Hospital, Lahore.
Methodology: The analysis comprised of 74 female patients out of which 26 were with high blood sugar, 24 high
blood sugar with coronary artery disease (CAD) and 24 were healthy. All the enrolled patients were sorted out
casually. Blood samplings with fasting were gotten from the patients and observed for serum adiponectin intensity,
fasting blood glucose (FBG), very low-density lipoprotein cholesterol (VLDL-C), Low density cholesterol (LDL-C),
High density lipoprotein cholesterol (HDL-C), total cholesterol (TC), triglycerides (TG) and glycosylated
hemoglobin (HbA1c)
Results: The intensity of serum adiponectin and intensity of HbA1c and FBG was instantly minimum and maximum
respectively where the value of P was less than 0.001 both found as a matching between type 2 high blood sugar
female patients having presence and absence of coronary artery disease (CAD) and healthy women. Negative
relativity of adiponectin with FBG where r was - 0.874, value of P was less than 0.01, r - 0.497, value of P was less
than 0.01, Triglycerides where r was -0.669, value of P was less than 0.01, r - 0.790, value of P was less than 0.01,
total cholesterol where r was - 0.423, value of P was 0.039, r - 0.733, value of was less than 0.01 and HbA1c where
r was -0.937 , P value was less than 0.01, r - 0.814 , P value was less than 0.01 was observed in female participated
patients of high blood sugar in the presence and absence of CAD. All three groups which were comprising of
healthy females where r was 0.988 with value of P less than 0.01, type 2 high blood sugar with the presence of
coronary artery disease where r was 0.775 with P value less than 0.01 and type 2 high blood sugar with the absence
of coronary artery disease where r was 0.908 with the P value less than 0.01 shown an instant positive relativity of
adiponectin.
Conclusion: Intensity of serum adiponectin is significantly decreased in female patients of type 2 high blood sugar
with the presence and absence of coronary artery disease. Furthermore, the hypoadiponectinemia in these female
patients is associated with un-balanced glycemic condition and intensity of abnormal lipid profile throughout the
flow.
Key words: Lipid profile, Type 2 diabetes mellitus, Glycemic status, Adiponectin, coronary artery disease (CAD).

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Corresponding author:
Dr. Sidra Nisar, QR code
Combined Military Hospital, Lahore.

Please cite this article in press Sidra Nisar et al., Association Of Hypoadiponectinemia To A Complete Cholesterol
Test And Glycemic Condition In Females With Type 2 Diabetes In The Presence And Absence Of Coronary
Artery Disease (Cad)., Indo Am. J. P. Sci, 2019; 06(06).

INTRODUCTION: The role of adiponectin in type 2 differs with the pre-

Type 2 high blood sugar with group of metabolic existing vascular ailment, race, lifestyle differences,
disorders characterized by high blood sugar intensity gender and age [10]. We have performed matching of
over a prolonged period is raising in the popularity intensity of serum adiponectin among normal female
and grown as a universal issue. A most usual patients and female patients with type 2 high blood
category of high blood sugar is type 2 diabetes sugar having presence and absence of coronary artery
mellitus (DM) and accountable in people with high disease and strained to develop an association among
blood sugar above than a percentage of 90.0 % and it hypoadiponectinemia and lipid profile and glycemic
influences grown up people with the percentage of level in the analyzed number of people through this
5.1 % [1]. It is developing rapidly which is found as a analysis.
value of percentage 3.0 % annually and is probable to
harm approximately 330 million of population in the MATERIAL AND METHODS:
world till the year 2030 [2]. The occurrence of high The analysis comprised of 74 female patients out of
blood sugar is found maximum in Pakistan which 26 were with high blood sugar, 24 high blood
undergoing the limits between percentage of 7.6 % to sugar with coronary artery disease (CAD) and 24
11.0 % [3]. Pakistani high blood sugar people might were healthy. All the enrolled patients were sorted
raise with the number of 5.2 million to 13.9 million out casually. Blood samplings with fasting were
from the year 2000 to 2030 reported by Wild et al. gotten from the patients and observed for serum
the coronary artery disease is one of the usual adiponectin intensity, fasting blood glucose (FBG),
complexities of high blood sugar mellitus and it goes very low-density lipoprotein cholesterol (VLDL-C),
through the maximum mortalities alone than the Low density cholesterol (LDL-C), High density
combined mortalities causing through cancer, chronic lipoprotein cholesterol (HDL-C), total cholesterol
lower respiratory disease, accidents and DM [4]. The (TC), triglycerides (TG) and glycosylated
occurrence of coronary artery disease is thought to be hemoglobin (HbA1c). This analysis was comprised
two times from the year 1990 to 2020 and raise with of three groups A, B and C. group A was consisting
the percentage of 82.0 % would be happened by the of controlled healthy female enrolled patients with
raised load in the progressing countries else than the the number of 24 which have no main disease like
progressed countries [5]. Adiponectin has currently diseases of kidney or thyroid, coronary artery disease,
concerned more courtesy because it got extensive part diabetes mellitus (DM). Female high blood sugar
in health and ailment as it was analyzed before in the enrolled patients with the number of 26 were
year 1995 [6]. It is concealed with adipose tissue included in Group B having type 2 high blood sugar
besides to adipokines and is a protein hormone mellitus since last four years. Number of 24 type 2
consisting amino acids 244 [7]. Adiponectin high blood sugar female enrolled patients having
molecules have the aptitude to self – subordinate and coronary artery disease which were treated with first
present in minimum three maximum order complicate heart attack in the duration of last 10 days were
states named as low molecular weight form (LMW), included in Group C. A well- developed survey was
medium molecular weight form (MMW) and high processed to state the BP, weight, height, BMI and
molecular weight form (HMW) [8]. Adiponectin literature of the selected patients where the weight
influences carbohydrates and plays a role as insulin was expressed in Kg and Hight in m2. Total
sensitizing, anti-inflammatory, anti-hyperlipidemic, conversant written agreement was collected from the
anti-hypertensive, cardio-protective and anti- total enrolled patients and verification of the analysis
atherogenic representative [9]. The act of adiponectin was gotten from the Ethical Committee of Services
in type 2 DM and CAD. Hospital, Lahore.

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healthy women. Negative relativity of adiponectin

Approximately 5.0 ml of fasting blood samplings was with FBG where r was - 0.874, value of P was less
obtained from total selected patients and 3.0 ml than 0.01, r - 0.497, value of P was less than 0.01,
clotted blood was processed by centrifugation Triglycerides where r was -0.669, value of P was less
apparatus for getting clear serum at 4000 rpm for 5 than 0.01, r - 0.790, value of P was less than 0.01,
minutes to 10 minutes. Lipid profile and fasting total cholesterol where r was - 0.423, value of P was
blood glucose were evaluated through processing of 0.039, r - 0.733, value of was less than 0.01 and
fresh samplings. Samplings gathered in the EDTA HbA1c where r was -0.937 , P value was less than
tubes were processed for the evaluation of 0.01, r - 0.814 , P value was less than 0.01 was
glycosylated hemoglobin. The serum stored at -70.0 observed in female participated patients of high blood
degree centigrade was used to predict the intensity of sugar in the presence and absence of CAD.
adiponectin. Biochemical analysis: enzymatic
colorimetric procedure was processed to evaluate the All three groups which were comprising of healthy
fasting blood glucose, serum triglyceride and serum females where r was 0.988 with value of P less than
total cholesterol through kits gotten by Elitech -Sees, 0.01, type 2 high blood sugar with the presence of
in France. High density lipoprotein cholesterol was coronary artery disease where r was 0.775 with P
predicted calorimetrically through equipment given value less than 0.01 and type 2 high blood sugar with
by Diasys Holzhem, in Germany. Low density the absence of coronary artery disease where r was
lipoprotein cholesterol (LDL – C) and VLDL – C 0.908 with the P value less than 0.01 shown an
were evaluated through Friedewal’s formula and instant positive relativity of adiponectin. Group A
Delongs formula accordingly [11,12]. comprised of number of 24 healthy female patients
with average age of 44 years where the standard
The evaluation of Glycosylated hemoglobin was deviation is ± 4.6, Group B comprised of number of
processed calorimetrically through the equipment 26 type 2 high blood sugar female patients having
given by Human Diagnostic in Germany. The average age of 56.8 years where standard deviation is
prediction of intensity of Adiponectin was processed ± 11.3 and Group C comprised of type 2 high blood
through Human adiponectin ELISA equipment where sugar female patients having coronary artery disease
the Bio-vendor [Link]. RD 195023100 in Germany. with average age of 58.7 years where standard
The information was studied through SPSS 19. The deviation is ± 9.1. Intensity of serum adiponectin was
outcomes were presented as Average ± Standard maximum in the control group that is 12.7 ± 2.5 as a
Deviation. Matching of different values between the matching difference from type 2 high blood sugar
groups was processed through independent student’s female patients that is 3.3 ± 1.4 and type 2 high blood
examination. Value of P was less than 0.05 suggested sugar female patients of coronary artery disease
as definite. The relativity of adiponectin with which is 3.5 ± 1.1. Intensity of serum HDL – C was
glycosylated hemoglobin, fasting lipid profile and minimum in type 2 high blood sugar female patients
fasting blood glucose was observed by Pearson’s with CHD where average and SD was 35.04 ± 7.7
correlation coefficient. versus type 2 high blood sugar female patients and
RESULTS: the control female patients where average and SD
The intensity of serum adiponectin and intensity of was 39.04 ± 1.3 and 43.5 ± 10.6 respectively. The
HbA1c and FBG was instantly minimum and matching of the two alimented groups was indefinite
maximum respectively where the value of P was less almost both presented lesser glycemic control and
than 0.001 both found as a matching between type 2 unbalanced lipid profile. Details of the above given
high blood sugar female patients having presence and outcomes are shown below in following tabular
absence of coronary artery disease (CAD) and forms.

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Table No 01: Demographic, clinical and biochemical characteristics of all groups

Variables Group A Group B Group C
Age (years) 44 ± 4.60 56.8 ± 11.3 58.7 ± 9.1
BMI (kg/m2) 28.8 ± 3.30 27.1 ± 4.20 27.9 ± 3.02
SBP (mmHg) 123.1 ± 8.50 136.9 ± 18.7 128.5 ± 31.7
DBP (mmHg) 80 ± 4.10 85.5 ± 9.80 86.04 ± 14.5
FBG (mg/dL) 96.0 ± 12.5 182.7 ± 83.3 208.7 ± 111.3
HbA1C (%) 5.1 ± 0.41 8.1 ± 1.20 8.8 ± 1.60
TC (mg/dL) 186.6 ± 29.5 223.6 ± 37.5 215.3 ± 45.8
TG (mg/dL) 183.1 ± 73.8 251.7 ± 77.02 218.1 ± 75.2
HDL – C (mg/dL) 43.5 ± 10.6 39.04 ± 11.3 35.04 ± 7.70
LDL – C (mg/dL) 106.1 ± 29.3 134.1 ± 36.8 136.7 ± 41.8
VLDL – C (mg/dL) 36.4 ± 14.9 50.4 ± 15.5 43.5 ± 15.1
Adiponectin (μg/mL) 12.7 ± 2.5 3.3 ± 1.4 3.5 ± 1.1
Body mass index (BMI); Systolic blood pressure (SBP); Diastolic blood
pressure (DBP); Fasting blood glucose (FBG); Total cholesterol (TC);
Triglycerides (TG); High density lipoprotein – cholesterol (HDL – C);
Low density lipoprotein – cholesterol (LDL – C).
{Data is expressed as mean ± SD}

GROUP WISE MEAN AGE

56.8 58.7
60
50 44
40
30
20 11.3 9.1
10 4.6
0
Group A Group B Group C

Mean Age ±SD

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Table No 02: Matching of various characteristics among the analyzed groups

Group A with Group A with Group B with
Variables
group B group C Group C
Age < 0.001 < 0.001 NS
BMI NS NS NS
SBP < 0.05 NS NS
DBP < 0.05 NS NS
FBG < 0.001 < 0.001 NS
HbA1c < 0.001 < 0.001 NS
TC < 0.05 < 0.05 NS
TG < 0.05 NS NS
HDL – C NS < 0.05 NS
LDL – C < 0.05 < 0.05 NS
VLDL – C < 0.05 NS NS
Adiponectin < 0.001 < 0.001 NS
P value is significant at < 0.05 and < 0.001 level, NS nonsignificant

Table No 03: Correlation of adiponectin with different parameters in the analyzed groups
Group A Group B Group C
Variables
r p r p r p
Age -0.96 0.654 0.117 0.568 -0.130 0.545
BMI -0.136 0.526 -0.190 0.354 -0.244 0.251
** **
HDL-C 0.988 <0.01 0.908 <0.01 0.775 <0.01**
LDL-C -0.104 0.629 -0.707 <0.01** -0.367 0.077
** **
VLDL-C -0.532 0.007 -0.793 <0.01 -0.668 <0.01**
SBP -0.089 0.680 0.103 0.617 -0.096 0.654
DBP -0.167 0.435 0.148 0.471 -0.085 0.694
**
FBG 0.285 0.223 -0.497 0.010 -0.874 <0.01**
HbA1C -0.160 0.456 -0.814 <0.01** -0.937 <0.01**
TC -0.030 0.889 -0.733 <0.01** -0.423 0.039*
TG -0.515 0.010* -0.790 <0.01** -0.669 <0.01**
*
Significance at 0.05 level, **Significance at 0.01 level

DISCUSSION: blood sugar mellitus [15]. The actual biochemical

Insulin resistance evaluates for the major cause of experience by which the glucose metabolism is
type 2 diabetes mellitus DM delivering affected by adiponectin is indistinct till now although
hyperglycemia as the major analytic and predictive many experiences were offered. Adiponectin is a
aggressive disease [13]. Better glycemic control of molecule or gene that cause aggressive disease of
these patients needs HbA1 decrease to less than 7.0 liver peroxisome – proliferator activation receptor γ
% [14]. Adiponectin is major factor of glucose (PPAR γ) which enhances it to be an insulin
metabolism and hypoadiponectinemia is observed to sensitizing representative [16]. If the mice analyzed
be associated with insulin resistance and type 2 high by a geniting material formed by recombination of

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adiponectin after cholesterol maximum diet shows sugar patients in the presence and absence of
reduced circulating intensities of glucose and free coronary artery disease. Similar outcomes were stated
cholesterol acids. This is clarified because of through other analyses [29]. Adiponectin was
adiponectin activation of AMP activated protein observed to be negatively relative to fasting blood
kinase (AMPK) relating to raised cholesterol acid glucose, triglycerides and glycosylated hemoglobin
oxidation and muscular acceptance of glucose [17]. and positively relative to maximum density
lipoprotein cholesterol in type 2 high blood sugar
It is observed that the processing of insulin female patients with CAD and without CAD. Same
sensitizing representatives such as thiazolidinedione outcomes were gotten through else analyses [30].
and proglitazone in high blood sugar persons follow Few analyses opposed the defensive act of
towards raise absorption of adiponectin [18]. Type 2 adiponectin in contradiction of coronary artery
DM were almost associated with polymorphism of disease although till now there is no opposition
adiponectin molecule (apM1), that is existed on a regarding the useful act of adiponectin in type 2 high
high blood sugar vulnerability locus available at blood sugar mellitus [31,32].
chromosome 3q27 [19]. Adiponectin is able in
serving to protect the hear. It initiates peroxisome – CONCLUSION:
proliferator activation receptor α (PPARα), controls Decreased intensity of adiponectin and HDL – C and
adhesion molecules and prevents indications of increased intensity of TG in type 2 high blood sugar
nuclear factor kB [20]. Adiponectin refers to raised females in the presence and absence of coronary
development of nitric oxide that helps in controlling artery disease is verified by our analyses.
the BP and prevents the cardiac myocytes from Furthermore, adiponectin presented definite negative
hypertrophy in influence to stress overload through relativity to TG, FBG and HbA1c and definite
the AMPK initiation in cardiovascular structure [21]. positive relativity to HDL – C in the analyzed
Adiponectin provide security to atherogenesis by number of people. Intensity of serum adiponectin is
enhancing reduced proliferation of smooth cells of significantly decreased in female patients of type 2
muscle and preventing macrophage revolution to high blood sugar with the presence and absence of
foam cell [22]. Reduced intensities of adiponectin coronary artery disease. Furthermore, the
reduce HDL cholesterol and raises triglycerides due hypoadiponectinemia in these female patients is
to reduced PPAR α initiation, decreased lipoprotein associated with un-balanced glycemic condition and
lipase function and raised VLDL configuration [23]. intensity of abnormal lipid profile throughout the
flow.
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