Plasma leptin is independently associated with the intima-media thickness of the common carotid artery
Plasma leptin is independently associated with the intima-media thickness of the common carotid artery
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DOI：
10.1038/sj.ijo.0801623
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发表时间：
2001-06-01
影响因子：
4.9
通讯作者：
De Pergola, G
中科院分区：
文献类型：
--
作者：
Ciccone, M;Vettor, R;De Pergola, G
目的：研究颈总动脉（CCA）的内膜中层厚度（IMT），无症状动脉粥样硬化的早期标志物，是否与瘦素的血浆浓度显著相关，瘦素是一种脂肪组织激素，最近被认为是肥胖患者的心血管危险因素。设计：正常体重和肥胖男性和女性的横断面样本。受试者：招募了120名健康受试者（52名男性和68名女性），年龄在18-45岁之间，具有广泛的BMI，用于该研究。采用放射免疫法测定血清瘦素浓度，高分辨率B超成像法测定颈总动脉内膜中层厚度。中央脂肪（以腰围测量）、吸烟习惯、血压、胰岛素敏感性（通过胰岛素耐量试验测量）和空腹血糖、胰岛素和血脂模式还测量了（胆固醇、HDL-胆固醇、甘油三酯、LDL-胆固醇）。颈总动脉IMT与log瘦素浓度呈正相关（男性P < 0.005，女性P < 0.001），体重指数（男女P < 0.001）、腰围（男女P < 0.001）、年龄（男性P <0.001，女性P < 0.05），男女均与胰岛素敏感性呈负相关（P < 0.05）。男性IMT与胆固醇（P < 0.05）、低密度脂蛋白胆固醇（P < 0.01）、收缩压（P < 0.05）呈显著正相关，女性IMT与舒张压（P < 0.05）呈显著正相关。当使用多元线性回归模型时，在没有体重指数（BMI）的情况下，瘦素与IMT之间的相关性在男性（P < 0.01）和女性（P < 0.005）中均保持不变，与年龄、胰岛素敏感性、吸烟习惯、收缩压、空腹血糖、甘油三酯、胆固醇、LDL-胆固醇和HDL-胆固醇无关。相比之下，BMI调整的瘦素浓度与IMT无显著相关性（Pc（偏相关）：男性0.41，女性0.15）。此外，当BMI进入多元线性回归模型，没有瘦素，BMI和IMT之间的相关性在两个男人都保持不变（P < 0.005）女性（P < 0.01），与相同参数无关。血浆瘦素浓度与颈总动脉IMT独立相关，表明脂肪组织质量（或瘦素本身）的增加可能对动脉粥样硬化的发展具有不利影响。然而，IMT和瘦素之间的关联似乎是依赖和/或混淆的IMT和肥胖之间的关系。
OBJECTIVE: To investigate whether intima-media thickness (IMT) of the common carotid artery (CCA), an early marker of asymptomatic atherosclerosis, is significantly and independently associated with plasma concentrations of leptin, an adipose tissue hormone that has recently been proposed as a cardiovascular risk factor in obese patients.DESIGN: Cross-sectional sample of normal-weight and obese men and women. SUBJECTS: One-hundred and twenty healthy subjects (52 men and 68 women), aged 18-45 y and with a wide range of BMI, were recruited for the study.MEASUREMENTS: Fasting plasma leptin concentrations and the IMT of the CCA were measured in all subjects. Leptin concentrations were measured by radioimmunoassay and the IMT of the CCA was quantified by high resolution B-mode ultrasound imaging. Central fat (measured by waist circumference), smoking habits, blood pressure, insulin sensitivity (measured by the insulin tolerance test), and fasting plasma glucose, insulin and lipid pattern (cholesterol, HDL-cholesterol, triglycerides, LDL-cholesterol) were also measured.RESULTS: IMT of the CCA was positively correlated with log leptin concentrations (P < 0.005 in men and P < 0.001 in women), body mass index (P < 0.001 in men and women), waist circumference (P < 0.001 in men and women), age (P < 0.001 in men and P < 0.05 in women), and negatively associated with insulin sensitivity in both sexes (P < 0.05). IMT was also directly correlated with cholesterol (P < 0.05), LDL-cholesterol (P < 0.01) and systolic blood pressure in men (P < 0.05), and with diastolic blood pressure levels in women (P < 0.05). When a multiple linear regression model was used without body mass index (BMI), the correlation between leptin and IMT was maintained in both men (P < 0.01) and women (P < 0.005), independent of age, insulin sensitivity, smoking habits, systolic blood pressure, fasting glucose, triglycerides, cholesterol, LDL-cholesterol and HDL-cholesterol. By contrast, BMI-adjusted leptin concentrations were not significantly associated with IMT (Pc (partial correlation): 0.41 in men and 0.15 in women). Moreover, when BMI was entered into a multiple linear regression model without leptin, the correlation between BMI and IMT was maintained in both men (P < 0.005) and women (P < 0.01), independent of the same parameters.CONCLUSION: Plasma leptin concentrations are independently associated with the IMT of the CCA, suggesting that the increase of adipose tissue mass (or leptin per se) may have an unfavourable influence on the development of atherosclerosis. However, the association between IMT and leptin seems to be dependent and/or confounded by the relationship between IMT and obesity.