Plasma adiponectin distribution in a Mediterranean population and its association with cardiovascular risk factors and metabolic syndrome.

Adiponectin may play an important role in the regulation of body weight, insulin resistance, and cardiovascular disease. The aim of this study was to evaluate the distribution of adiponectin in a Mediterranean adult population and its relationship with cardiovascular risk factors and metabolic syndrome. A cross-sectional study was performed in a representative sample of 1023 subjects from a Spanish Mediterranean population. Individuals with the metabolic syndrome were identified using the diagnostic criteria of the Adult Treatment Panel III. Anthropometric parameters were measured, and biochemical analyses were performed in fasting conditions. Plasma insulin levels were measured and homeostasis model assessment of insulin resistance was calculated. Plasma adiponectin levels were measured by a commercial radioimmunoassay. Median levels of adiponectin were significantly higher in women than in men after adjusting for differences in body mass index. However, no differences in adiponectin plasma levels were observed in relation to age. Significantly lower levels of adiponectin were also observed in women with obesity, abdominal obesity, hyperglycemia or diabetes, low high-density lipoprotein cholesterol, hypertriglyceridemia, or metabolic syndrome. In men, only those with obesity, abdominal obesity, low high-density lipoprotein cholesterol, hypertriglyceridemia, or metabolic syndrome showed significantly lower plasma levels of adiponectin. In a stepwise multivariate analysis, sex, waist circumference, serum C-reactive protein serum levels, and homeostasis model assessment of insulin resistance explained 23.4% of its variability. In conclusion, adiponectin plasma levels are more closely related to the components of the metabolic syndrome in women than in men in a Mediterranean population.

[Value of troponins in acute coronary syndrome in patients with renal failure]. / Interés de las troponinas en el síndrome coronario agudo en pacientes con insuficiencia renal.

Patients with renal insufficiency can have elevations of serum troponin without suspected clinical coronary ischemia. Although cardiovascular disease is the main cause of death in patients with renal failure, the process of elevation of serum troponin is not well known. Troponin T is more frequently elevated than troponin I in these patients which leads to uncertainty in the clinical interpretation of results. There are studies suggesting that troponin elevations are associated with a higher risk and increased mortality. To explain the process leading to troponin increases in this kind of pathology and to confirm its usefulness in the diagnosis, evolution and prognosis it would be necessary to carry out more clinical studies monitoring troponin and studying the stratification of risk.

Interés de las troponinas en el síndrome coronario agudo en pacientes con insuficiencia renal / Value of troponins in acute coronary syndrome in patients with renal failure

Los pacientes con insuficiencia renal pueden tener elevaciones de troponina en suero aun en ausencia de sospecha clínica de isquemia coronaria. Aunque la enfermedad cardiovascular sea la principal causa de muerte en pacientes con insuficiencia renal, el mecanismo de elevación de las troponinas séricas no está bien establecido. La troponina T está más frecuentemente elevada que la troponina I en este tipo de pacientes lo que provoca incertidumbre en la interpretación clínica de los resultados. A pesar de desconocer el mecanismo de elevación de las troponinas en la insuficiencia renal, hay estudios que sugieren que las elevaciones de troponina se asocian a riesgo e incremento de mortalidad. Para esclarecer cuál es el mecanismo por el que se incrementan las troponinas en este tipo de patología, así como confirmar su utilidad en el diagnóstico, evolución y pronóstico, sería necesario efectuar más estudios clínicos monitorizando la troponina y estudiando la estratificación de riesgo (AU)

Analytical evaluation of two automatic methods to measure blood CK-MB mass and troponin I.

The lack of standardization of methods to measure cardiac markers for coronaria ischaemia, particularly troponin, led us to perform an analytical evaluation of two new immunoassays to quantify CK-MB mass and troponin I using the Dimension RxL automatic analyser. The reliability and analytical intervals of the methods were studied as well as reference values (0.010- 0.228 microg l(-1) for troponin I, 0.20-3.90 microg l(-1) for CK-MB mass) and cuto inverted exclamation mark values (0.77 microg l(-1) for troponin I, 5 microg l(-1) for CK-MB mass) established. The cutoff values were established from 37 patients with acute myocardial infarction and from 20 with unstable angina. The absence of method cross-reactivity was corroborated using myocardial, brain and skeletal muscle tissue. Both methods were highly specific and showed good reliability and practicability in the diagnosis of coronaria ischaemia after 6 h of precordial pain.