Why the study?
Coronary artery disease is a leading cause of global mortality with higher prevalence in type 2 diabetes mellitus, but limited data exist on biomarker interactions in CAD patients with and without T2DM.
Reduced adiponectin (≤5.0 mg/L) and elevated inflammatory markers are significantly associated with CAD and metabolic dysfunction, particularly in patients with concurrent type 2 diabetes, suggesting potential utility for cardiovascular risk stratification.
Adiponectin reduction associates with CAD in T2DM; leaves open biomarker utility for stratification pending prospective validation.
ABSTRACT Background: Coronary artery disease [CAD] remains a leading cause of global mortality, with higher prevalence among individuals with type 2 diabetes mellitus [T2DM]. Limited data exist on biomarker interactions in CAD patients with and without T2DM. Objective: This study aimed to investigate correlations among adiponectin, inflammatory markers, and metabolic factors in CAD patients and evaluate their association with T2DM status. Methods: A cross-sectional study enrolled 225 participants: 75 healthy controls, 75 CAD patients with T2DM, and 75 CAD patients without T2DM. Serum levels of adiponectin, hs-CRP, IL-6, E-selectin, insulin, and C-peptide were measured using ELISA. Lipid profiles were analyzed via automated analyzer. Statistical analysis included ANOVA, correlation analysis, multicollinearity assessment, regression, and ROC analysis. Results: All biomarkers showed significant differences across groups [p<0.05]. Adiponectin levels were lowest in CAD with T2DM [4.2 ± 1.0 mg/L vs 7.4 ± 1.6 mg/L in controls, p<0.001]. Inflammatory markers were elevated in both CAD groups, with highest levels in diabetic patients. ROC analysis revealed moderate discriminative ability: adiponectin [AUC=0.79], hs-CRP [AUC=0.83], E-selectin [AUC=0.75], and insulin [AUC=0.72]. In the multivariable regression model, insulin emerged as the superior insulin-secretion marker over C-peptide, after accounting for multicollinearity and excluding participants with renal impairment. Conclusion: This study demonstrates significant associations between reduced adiponectin, elevated inflammatory markers, and metabolic dysfunction in CAD patients, particularly those with T2DM. An adiponectin threshold of ≤5.0 mg/L may serve as a practical clinical alert for high cardiovascular risk in diabetic patients. These findings warrant further prospective investigation to determine their potential clinical utility.
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Pattapu et al. (2026) studied this question.
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