Prognostic value of adiponectin for cardiovascular disease and mortality
Prognostic value of adiponectin for cardiovascular disease and mortality
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DOI：
10.1210/jc.2007-1436
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发表时间：
2008-04-01
影响因子：
5.8
通讯作者：
Heine, Robert J.
中科院分区：
文献类型：
--
作者：
Dekker, Jacqueline M.;Funahashi, Tohru;Heine, Robert J.
目的：我们研究了脂联素水平对全因和心血管疾病死亡率和心血管疾病发病率的预测价值。设计、背景和参与者：这是一项在荷兰霍恩进行的基于人群的队列研究，始于1989年，包括2484名年龄在50-75岁之间的参与者。主要观察指标：计算脂联素对全原因和心血管疾病死亡率和心血管疾病发病率的风险比(HRs)，每改变一次的可信区间为95%。结果：确定了1077名男性和1248名女性的脂联素。较高的脂联素水平降低了女性患非致命性心血管疾病的风险[女性和男性的95%可信区间分别为0.72(0.61-0.90)和0.92(0.79-1.06)]，但不降低全因或心血管疾病死亡的风险。相反，在调整心血管危险因素后，较高的脂联素是全因和心血管疾病死亡率的显著预测因子[女性心血管疾病死亡率的比率为1.45(1.10-1.92)，男性为1.30(1.04-1.63)]。在心血管疾病患者中，脂联素水平较高与心血管疾病死亡的风险增加相关[HR 1.27(0.98-1.63)]，而在非心血管疾病患者中则与风险降低[HR 0.90(0.73-1.11)]相关。调整心血管危险因素后，心血管病死率为1.60(1.14~2.23)，非心血管病患者为1.38(1.06~1.80)。结论：脂联素水平高可预测死亡率，尤其是心脑血管疾病高发者。我们假设脂联素可以预防代谢和血管疾病，但在已经患有心血管疾病的患者中，脂联素代偿性上调，因此预示着高死亡风险。
Context: Low adiponectin concentrations are associated with the presence of an adverse cardiovascular disease (CVD) risk profile.Objective: We studied the predictive value of adiponectin levels for all-cause and CVD mortality and CVD morbidity.Design, Setting, and Participants: This was a population-based cohort study in Hoorn, The Netherlands, which started in 1989 and included 2484 participants, aged 50-75 yr.Main Outcome Measures: Hazard ratios (HRs) with 95% confidence interval per SD change in log-adiponectin for all-cause and CVD mortality and CVD morbidity were calculated.Results: Adiponectin was determined for 1077 men and 1248 women. Higher adiponectin reduced the risk of nonfatal CVD in women [HR with 95% confidence interval 0.72 (0.61-0.90) in women and 0.92 (0.79-1.06) in men], but not the risk of all-cause or CVD mortality. In contrast, after adjustment for cardiovascular risk factors, higher adiponectin was a significant predictor of all-cause and CVD mortality [HR for CVD mortality 1.45 (1.10-1.92) in women and 1.30 (1.04-1.63) in men]. Higher adiponectin was associated with an increased risk of CVD mortality in people with prevalent CVD [HR 1.27 (0.98-1.63)] and with reduced risk in people without [HR 0.90 (0.73-1.11)]. After adjustment for cardiovascular risk factors, the HRs for CVD mortality were 1.60 (1.14-2.23) for patients with and 1.38 (1.06-1.80) for patients without prevalent CVD.Conclusions: High levels of adiponectin predict mortality, in particular in patients with prevalent CVD. We hypothesize that adiponectin protects against metabolic and vascular diseases, but in patients already afflicted with CVD, adiponectin is compensatory up-regulated and, therefore, indicates a high mortality risk.