Adiponectin and future coronary heart disease events among men with type 2 diabetes
Adiponectin and future coronary heart disease events among men with type 2 diabetes
复制标题
DOI：
10.2337/diabetes.54.2.534
复制
发表时间：
2005-02-01
期刊：
影响因子：
7.7
通讯作者：
Hu, FB
中科院分区：
文献类型：
--
作者：
Schulze, MB;Shai, I;Hu, FB
脂联素主要在脂肪组织中合成，似乎具有显著的抗炎特性，并且是胰岛素抵抗和血脂异常的主要调节剂，其机制与糖尿病患者中动脉粥样硬化风险增加相关。然而，尚不清楚高水平的脂联素是否与糖尿病患者冠心病（CHD）风险降低有关。我们在健康专业人员随访研究中调查了745例确诊为2型糖尿病的男性患者血浆脂联素水平与冠心病发病率之间的关系。参与者年龄在46-81岁之间，在1993/1994年抽血时没有诊断出心血管疾病。在平均5年的随访（3，980人年）中，我们发现了89例CHD事件病例（19例心肌梗死和70例冠状动脉搭桥手术），并得到了医疗记录的证实。脂联素水平与BMI呈负相关，与年龄、饮酒量和糖尿病病程呈正相关（P < 0.05）。校正年龄、BMI、吸烟、饮酒、糖尿病病程和其他生活方式因素后，脂联素与冠心病事件风险降低相关。脂联素加倍的冠心病多变量相对危险度为0.71（95%CI 0.53-0.95）。进一步调整HDL胆固醇减弱了这种关联（0.78 [0.57-1.06]）。脂联素与CHD之间的负相关性在阿司匹林使用、心肌梗死家族史、饮酒、胰岛素使用、糖尿病病程、HbA（lc）、甘油三酯、C反应蛋白和HDL胆固醇水平等分层中一致。我们的研究表明，在男性糖尿病患者中，脂联素水平升高与冠心病风险适度降低相关。这种关联似乎部分是由脂联素对HDL胆固醇水平的影响介导的。
Adiponectin, predominantly synthesized in the adipose tissue, seems to have substantial anti-inflammatory properties and to be a major modulator of insulin resistance and dyslipidemia, mechanisms that are associated with an increased atherosclerotic risk in diabetic patients. However, it is unknown whether higher levels of adiponectin are associated with a reduced risk for coronary heart disease (CHD) among diabetic individuals. We investigated the association between plasma adiponectin levels and incidence of CHD among 745 men with confirmed type 2 diabetes in the Health Professionals Follow-up Study. Participants were aged 46-81 years and were free of diagnosed cardiovascular disease at the time of blood draw in 1993/1994. During an average of 5 years of follow-up (3,980 person-years), we identified 89 incident cases of CHD (19 myocardial infarction and 70 coronary artery bypass surgery), confirmed by medical records. Levels of adiponectin were inversely associated with BMI and directly associated with age, alcohol intake, and duration of diabetes (P < 0.05). After adjustment for age, BMI, smoking, alcohol consumption, duration of diabetes, and other lifestyle factors, adiponectin was associated with a decreased risk for CHD events. The multivariate relative risk for CHD for a doubling of adiponectin was 0.71 (95% CI 0.53-0.95). Further adjustment for HDL cholesterol attenuated this association (0.78 [0.57-1.06]). The inverse association between adiponectin and CHD was consistent across strata of aspirin use, family history of myocardial infarction, alcohol consumption, insulin use, duration of diabetes, and levels of HbA(lc), triglycerides, C-reactive protein, and HDL cholesterol. Our study suggests that increased adiponectin levels are associated with a moderately decreased CHD risk in diabetic men. This association seems to be mediated in part by effects of adiponectin on HDL cholesterol levels.