Associations of adiponectin and leptin with incident coronary heart disease and ischemic stroke in african americans: the jackson heart study.
Associations of adiponectin and leptin with incident coronary heart disease and ischemic stroke in african americans: the jackson heart study.
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DOI：
10.3389/fpubh.2013.00016
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发表时间：
2013
影响因子：
5.2
通讯作者：
Gibbons GH
中科院分区：
文献类型：
--
作者：
Bidulescu A;Liu J;Chen Z;Hickson DA;Musani SK;Samdarshi TE;Fox ER;Taylor HA;Gibbons GH
背景：由于先前报道的瘦素和脂联素水平的种族差异的预测意义尚不清楚，我们评估了这些脂肪因子与非裔美国人心血管疾病（CVD）事件风险的前瞻性关联，这是一个心脏代谢危险因素高发的人群。方法：在基线检查时分析了4,571名Jackson心脏研究参与者（2000-2004年）的血清脂联素和瘦素水平。采用Cox比例风险回归模型估计这两种脂肪因子与冠心病和缺血性脑卒中发生率的关系。结果：在平均6.2年的随访中，记录了98例冠心病事件和87例缺血性卒中事件。在研究参与者（64%女性，平均年龄54±13岁）中，脂联素的平均（标准差，SD）为女性6.04 (4.32)μg/mL，男性4.03 (3.14)μg/mL，瘦素的平均（标准差，SD）为女性37.35 (23.90)ng/mL，男性11.03 (10.05)ng/mL。在包括年龄、体重指数、高密度脂蛋白胆固醇、甘油三酯、c反应蛋白、胰岛素抵抗、收缩压、高血压药物、吸烟和身体活动在内的多变量调整后，脂联素在女性中与卒中事件直接相关，HR = 1.41 (1.04-1.91) / SD增加（p = 0.03），但在男性中没有（p = 0.42）。它与女性或男性冠心病的发生无关。瘦素与冠心病事件或卒中事件无关。结论：在最大的以社区为基础的非裔美国人队列中，脂联素与卒中发生率较高的女性相关。脂联素是否具有有害的特性，或者是为了对抗动脉粥样硬化过程而产生的血管炎症反应，或者是假定的“脂联素抵抗”现象的作用，都应该进一步评估。
Background: Because the predictive significance of previously reported racial differences in leptin and adiponectin levels remains unclear, we assessed the prospective association of these adipokines with the risk of cardiovascular disease (CVD) events in African Americans, a population with a high prevalence of cardiometabolic risk factors. Methods: Serum specimens from 4,571 Jackson Heart Study participants without prevalent CVD at baseline examination (2000–2004) were analyzed for adiponectin and leptin levels. Cox proportional hazard regression models were used to estimate the associations of the two adipokines with incident coronary heart disease (CHD) and incident ischemic stroke. Results: During 6.2 years average of follow-up, 98 incident CHD and 87 incident ischemic stroke events were documented. Among study participants (64% women; mean age 54 ± 13 years), the mean (standard deviation, SD) was 6.04 (4.32) μg/mL in women and 4.03 (3.14) μg/mL in men for adiponectin and 37.35 (23.90) ng/mL in women and 11.03 (10.05) ng/mL in men for leptin. After multivariable adjustment that included age, body mass index, high-density lipoprotein cholesterol, triglycerides, C-reactive protein, insulin resistance by homeostasis model assessment for insulin resistance, systolic blood pressure, hypertension medication, smoking, and physical activity, adiponectin was directly associated in women with incident stroke, HR = 1.41 (1.04–1.91) per one SD increase (p = 0.03), but not in men (p = 0.42). It was not associated with incident CHD in women or men. Leptin was not associated with incident CHD or incident stroke. Conclusion: In the largest community-based African American cohort, adiponectin was associated among women with a higher risk of incident stroke. Whether adiponectin harbors harmful properties, or it is produced in response to vascular inflammation to counter the atherosclerotic process, or the putative “adiponectin resistance” phenomenon acts, should be further assessed.