Multi-Biomarker Stratification of Coronary Artery Disease in Diabetic and Non-Diabetic Patients: Adiponectin, Inflammation, and Insulin Resistance

Leela Pattapu 1 * , Priya K Dhas 2 * , Mekhala K P 3, Ponnudhali D 2, Chakrapani Cheekavolu 4
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1 PhD Scholar, Department of Biochemistry, Vinayaka Mission's Kirupananda Variyar Medical college and Hospitals, VMRF (DU), Salem, Tamil Nadu, India
2 Department of Biochemistry, Vinayaka Mission's Kirupananda Variyar Medical College, Vinayaka Mission's Research Foundation (Deemed to be University), Salem-636308, Tamil Nadu, India
3 Department of Biochemistry, Karpagam Faculty of Medical Science & Research, Coimbatore, Tamil Nadu, India
4 Department of Pharmacology, Karpagam Faculty of Medical Science & Research, Coimbatore, Tamil Nadu, India
* Corresponding Author
J CLIN MED KAZ, Volume 23, Issue 2, pp. 57-63. https://doi.org/10.23950/jcmk/18010
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Author Contributions: Conceptualization, P.K.D. and K.P.M.; Methodology, L.P. and P.K.D.; Formal Analysis, J.T. and T.S.; Investigation, L.P. and A.C.; Resources, P.K.D.; Data Curation, L.P.; Writing – Original Draft Preparation, L.P. and P.K.D.; Writing – Review & Editing, K.P.M., J.T., T.S., and A.C.; Supervision, P.K.D.; Project Administration, P.K.D. All authors have read and agreed to the published version of the manuscript.

Data availability statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Artificial Intelligence (AI) Disclosure Statement: The authors declare no AI Tools used for preparation of this work.

ABSTRACT

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.
Keywords: adiponectin, biomarkers, coronary artery disease, hs-CRP, insulin resistance, type 2 diabetes mellitus

CITATION

Pattapu L, Dhas PK, K P M, D P, Cheekavolu C. Multi-Biomarker Stratification of Coronary Artery Disease in Diabetic and Non-Diabetic Patients: Adiponectin, Inflammation, and Insulin Resistance. J CLIN MED KAZ. 2026;23(2):57-63. https://doi.org/10.23950/jcmk/18010

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