Leptin, Adiponectin, and High-Sensitivity C-Reactive Protein in Relation to the Metabolic Syndrome in Urban South African Blacks With and Without Coronary Artery Disease

Background: Metabolic syndrome and coronary artery disease (CAD) are increasing in urban black South Africans during their transition from a rural to a western lifestyle. Inflammation is frequently associated with metabolic syndrome and CAD. This study evaluated markers of inflammation in black CAD patients, some of whom had metabolic syndrome. Methods: Metabolic syndrome was defined according to International Diabetes Federation criteria. Inflammatory markers leptin, adiponectin, and high-sensitivity C-reactive protein (hs-CRP) were measured in 40 patients and 20 control subjects. Results: Metabolic syndrome was present in 23 patients and absent in 17 patients. Leptin was the only significantly higher marker in patients with metabolic syndrome compared to patients without metabolic syndrome (P < 0.01). Leptin was higher in women than men (P < 0.01) and higher in both genders with metabolic syndrome (P < 0.03 and P < 0.04, respectively). Leptin levels rose significantly with increasing metabolic syndrome criteria (P < 0.05). hs-CRP concentrations were elevated in both patient groups. Positive correlations were found between leptin and body mass index (BMI) (r = 0.7107; P < 0.0001), waist circumference (WC) (r = 0.4981; P < 0.002), and hs-CRP (r = 0.3886; P < 0.02). Conclusions: Leptin differentiated between CAD patients with and without metabolic syndrome and determined metabolic syndrome status in women and men. Leptin was the only marker that increased with additional metabolic syndrome criteria. Elevated hs-CRP concentrations may indicate a low-grade inflammatory state in CAD patients. Association of leptin with BMI, WC, and hs-CRP revealed a close link with metabolic syndrome, obesity, and inflammation in urban black South African CAD patients.