Plasma leptin levels are associated with coronary atherosclerosis in type 2 diabetes
Plasma leptin levels are associated with coronary atherosclerosis in type 2 diabetes
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DOI：
10.1210/jc.2003-031676
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发表时间：
2004-08-01
影响因子：
5.8
通讯作者：
Kimmel, SE
中科院分区：
文献类型：
--
作者：
Reilly, MP;Iqbal, N;Kimmel, SE
瘦素信号可能促进动脉粥样硬化血栓形成并导致心血管疾病。然而，瘦素是否与人类动脉粥样硬化，不同于血栓形成，是未知的。我们在一项2型糖尿病的横断面研究中确定了血浆瘦素水平与冠状动脉钙化（CAC）的相关性，CAC是冠状动脉粥样硬化的一个指标。在调整了已建立的危险因素后，瘦素水平与CAC相关[瘦素增加5 ng/ml的比值比（95%置信区间）：1.31（1.10-1.55）; P = 0.002]。在进一步控制体重指数（BMI）后，瘦素仍与CAC相关[1.29（1.07-1.55）; P = 0.008]，腰围[1.30（1.09-1.57）; P = 0.003]、C反应蛋白（CRP）水平[1.28（1.07-1.55）; P = 0.008]和亚临床血管疾病[1.30（1.08-1.57）; P = 0.006]。将BMI（P = 0.97）、腰围（P = 0.55）或CRP（P = 0.39）添加到瘦素模型中未能改善模型的解释能力，而将瘦素添加到BMI（P = 0.029）、腰围（P = 0.006）或CRP（P = 0.005）模型中显著改善了模型。在控制肥胖和CRP后，2型糖尿病患者血浆瘦素水平与CAC相关。瘦素信号传导是否直接促进动脉粥样硬化或代表预防动脉粥样硬化性心血管疾病的治疗靶点仍有待探索。
Leptin signaling may promote atherothrombosis and lead to cardiovascular disease. However, whether leptin is associated with human atherosclerosis, distinct from thrombosis, is unknown. We determined the association of plasma leptin levels with coronary artery calcification (CAC), a measure of coronary atherosclerosis, in a cross-sectional study of type 2 diabetes. Leptin levels were associated with CAC after adjusting for established risk factors [odds ratio (95% confidence interval) for 5 ng/ml leptin increase: 1.31 (1.10-1.55); P = 0.002]. Leptin remained associated with CAC after further controlling for body mass index (BMI) [1.29 (1.07-1.55); P = 0.008], waist circumference [1.30 (1.09-1.57); P = 0.003], C-reactive protein (CRP) levels [1.28 (1.07-1.55); P = 0.008], and subclinical vascular disease [1.30 (1.08-1.57); P = 0.006]. Addition of BMI (P = 0.97), waist (P = 0.55), or CRP (P = 0.39) to a model with leptin failed to improve the model's explanatory power, whereas addition of leptin to a model with BMI (P = 0.029), waist (P = 0.006), or CRP (P = 0.005) improved the model significantly. Plasma leptin levels were associated with CAC in type 2 diabetes after controlling adiposity and CRP. Whether leptin signaling promotes atherosclerosis directly or represents a therapeutic target for the prevention of atherosclerotic cardiovascular disease remains to be explored.