Cardiovascular death and the metabolic syndrome - Role of adiposity-signaling hormones and inflammatory markers
Cardiovascular death and the metabolic syndrome - Role of adiposity-signaling hormones and inflammatory markers
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DOI：
10.2337/dc05-2385
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发表时间：
2006-06-01
期刊：
影响因子：
16.2
通讯作者：
Barrett-Connor, Elizabeth
中科院分区：
文献类型：
--
作者：
Langenberg, Claudia;Bergstrom, Jaclyn;Barrett-Connor, Elizabeth
目的 - 肥胖信号激素和炎症标志物水平在代谢综合征患者中不太有利；它们在代谢综合征与心血管死亡率之间关联中的作用仍不清楚。
研究设计与方法 - 我们在1984 - 1987年对977名男性和1141名年龄在40 - 94岁的女性进行了一项前瞻性研究，对其死亡率进行了最长20年的随访。在1984 - 1987年采集的空腹血液样本中测量了脂联素、瘦素、胃饥饿素、白细胞介素 - 6（IL - 6）、C - 反应蛋白（CRP）以及成人治疗小组III定义的代谢综合征组分。在生存分析中使用了考克斯比例风险模型。
结果 - 与代谢综合征相关的冠心病（CHD）死亡率的年龄和性别调整后的风险比（HR）（95%置信区间）为1.65（1.25 - 2.18）（P < 0.001）；这种关联在性别、年龄或糖尿病状态方面没有显著差异（每种相互作用P > 0.2）。在对脂联素、瘦素和胃饥饿素进行调整后，代谢综合征与冠心病死亡率之间的关联没有实质性改变；在对IL - 6调整后减弱了25%，对CRP调整后减弱了35%。冠心病死亡率随着IL - 6和CRP水平的升高呈线性增加（每种的P趋势< 0.001）；年龄和性别调整后，比较最高和最低四分位数的HR分别为IL - 6是3.0（1.87 - 4.89），CRP是2.1（1.41 - 3.21）。在包括两种炎症标志物和代谢综合征的模型中，IL - 6（而非CRP）仍然是冠心病死亡率的显著预测因子。
结论 - 肥胖信号激素和炎症标志物对代谢综合征与冠心病死亡率之间的关联解释作用很小到一定程度。IL - 6水平可独立于CRP预测冠心病死亡率。
OBJECTIVE - Levels of adiposity-signaling hormones and inflammatory markers are less favorable in individuals with the metabolic syndrome; their role in the association between the metabolic syndrome and cardiovascular mortality remains unclear.RESEARCH DESIGN AND METHODS - We conducted a prospective study of 977 men and 1,141 women aged 40-94 years in 1984-1987, followed for mortality for a maximum Of 20 years. Adiponectin, leptin, ghrelin, interleukin-6 (IL-6), C-reactive protein (CRP), and Adult Treatment Panel Ill-defined metabolic syndrome components were measured in fasting blood samples obtained in 1984-1987. Cox-proportional hazards models were used in survival analyses.RESULTS - The age- and sex-adjusted hazard ratio (HR) (95% CI) for coronary heart disease (CHD) mortality associated with the metabolic syndrome was 1.65 (1.25-2.18) (P < 0.001); this association did not differ significantly by sex, age, or diabetic status (P > 0.2 for each interaction). The association between the metabolic syndrome and CHD mortality was not materially changed after adjustment for adiponectin, leptin, and ghrelin; it was attenuated by 25% after adjustment for IL-6 and 35% after adjustment for CRP. CHD mortality increased linearly with greater levels of IL-6 and CRP (P-trend < 0.001 for each); the age- and sex-adjusted HRs comparing highest versus lowest quarter were 3.0 (1.87-4.89) for IL-6 and 2.1 (1.41-3.21) for CRP. IL-6, but not CRP, remained a significant predictor of CHD mortality in models including both inflammatory markers and the metabolic syndrome.CONCLUSIONS - Adiposity-signaling hormones and inflammatory markers explain little to some of the association between the metabolic syndrome and CHD mortality. IL-6 levels predict CHD mortality independently of CRP.