The relation of leptin and insulin with obesity-related cardiovascular risk factors in US adults
The relation of leptin and insulin with obesity-related cardiovascular risk factors in US adults
复制标题
DOI：
10.1016/j.atherosclerosis.2007.11.015
复制
发表时间：
2008-09-01
期刊：
影响因子：
5.3
通讯作者：
Marshall, Simon J.
中科院分区：
文献类型：
--
作者：
Reis, Jared P.;Macera, Caroline A.;Marshall, Simon J.
以前的研究瘦素与心血管疾病（CVD）的危险因素受到限制的临床样本或缺乏代表性的一般人群。这项横断面研究旨在检测瘦素或胰岛素是否可能介导肥胖与代谢、炎症和血栓形成心血管危险因素的内源性关系，包括522名男性和514名女性，年龄≥ 40岁，他们在第三次全国健康和营养检查调查期间完成了体格检查。参与者没有现有的CVD，癌症（非黑色素瘤皮肤癌除外），糖尿病或呼吸系统疾病。在调整种族/民族和生活方式因素的多变量分析中，腰围（WC）与血压、甘油三酯、LDL胆固醇、总胆固醇：HDL比值、载脂蛋白B、C反应蛋白（CRP）和纤维蛋白原浓度呈正相关，与HDL胆固醇和载脂蛋白A1水平呈负相关。调整胰岛素水平后，WC与代谢性CVD危险因素的关联在很大程度上减弱，而WC与炎症和血栓形成因子（分别为CRP和纤维蛋白原）的关联在很大程度上可以通过调整瘦素浓度来解释。然而，瘦素水平与CRP和纤维蛋白原在男性和CRP在女性的WC调整后，没有独立相关。在女性中，瘦素和胰岛素与纤维蛋白原呈正相关，与WC无关。这些结果表明，胰岛素可能是肥胖与代谢相关的重要介质，而不是炎症或血栓形成的CVD危险因素，而瘦素似乎并没有通过与这些危险因素的共同关联来影响心血管风险。然而，我们不能排除瘦素和胰岛素通过对纤维蛋白原浓度的独立作用影响女性心血管风险的可能性。(C)2007爱思唯尔爱尔兰有限公司保留所有权利。
Previous studies of leptin with cardiovascular disease (CVD) risk factors have been limited by clinical samples or lack of representation of the general population. This cross-sectional study, designed to examine whether leptin or insulin may mediate the endogenous relation of obesity with metabolic, inflammatory, and thrombogenic cardiovascular risk factors, included 522 men and 514 women aged >= 40 years who completed a physical examination during the third National Health and Nutrition Examination Survey. Participants were free of existing CVD, cancer (except non-melanoma skin cancer), diabetes, or respiratory disease. In multivariable analyses adjusted for race/ethnicity and lifestyle factors, waist circumference (WC) was positively associated with blood pressure, triglyceride, LDL cholesterol, total cholesterol:HDL ratio, apolipoprotein B, C-reactive protein (CRP), and fibrinogen concentrations, and negatively associated with HDL cholesterol and apolipoprotein A1 levels. The associations of WC with the metabolic CVD risk factors were largely attenuated after adjustment for insulin levels, while the associations of WC with the inflammatory and thrombogenic factors (CRP and fibrinogen, respectively) were largely explained by adjustment for leptin concentrations. However, leptin levels were not independently associated with CRP and fibrinogen in men and CRP in women when adjusted for WC. Positive associations of leptin and insulin with fibrinogen in women, independent of WC, were noted. These results suggest that insulin may be an important mediator of the association of obesity with metabolic but not inflammatory or thrombogenic CVD risk factors, while leptin does not appear to influence cardiovascular risk through a shared association with these risk factors. However, we cannot rule out the possibility that leptin and insulin influence cardiovascular risk in women through independent effects on fibrinogen concentrations. (C) 2007 Elsevier Ireland Ltd. All rights reserved.