Adipokines, Sex Hormones and Cardiac Dysfunction in Postmenopausal Women of the MESA Study – An analysis of Secondary Data

摘要 绝经年龄是心力衰竭(HF)的性别特有的危险因素。尽管之前的研究已经证明 绝经年龄与亚临床心功能不全和心衰的关系及其确切机制 绝经年龄和心脏功能障碍尚不清楚。肥胖是已知的心力衰竭危险因素，它会变得 流行于更年期开始后。脂肪因子，如瘦素和脂联素，它们从 脂肪组织与亚临床心功能不全和症状性心衰有关。我们推测 脂肪因子在绝经年龄与心脏结构和功能的关系中发挥作用 随后与临床心力衰竭。这项建议的首要目标是检查血清的影响 脂肪因子对绝经年龄与心脏结构和功能关系的磁学测量 磁共振成像在动脉粥样硬化(MESA)多种族研究中的应用我们还将调查 脂肪因子在绝经年龄与心力衰竭(包括心力衰竭)发病关系中的调节作用 亚型)，考虑了绝经后的年数、性激素水平和使用台地的身体成分 数据。MESA提供全面的身体成分评估，包括身体质量指数、腰围 腰围、腰臀比、皮下脂肪和内脏的CT测量 脂肪组织、性激素和脂肪因子数据，MRI对心脏结构和功能的详细测量 和事件高频记录。这种方法说明了亚临床心脏的病理生理进展。 功能障碍转化为临床心力衰竭。MESA有关于保存和减少的射血分数HF的信息，进一步 使我们能够根据心力衰竭亚型探索关联。这项研究的结果将被用作试点 旨在进一步确定绝经后妇女心力衰竭特征的未来R01拨款的数据。

ABSTRACT Menopausal age is a sex-specific risk factor for heart failure (HF). Although prior studies have demonstrated associations of menopausal age with subclinical cardiac dysfunction and HF, the exact mechanisms that link menopausal age and cardiac dysfunction are not known. Obesity is a known HF risk factor that becomes more prevalent after menopause begins. Adipokines, such as leptin and adiponectin, which are released from adipose tissue, have been linked with subclinical cardiac dysfunction and symptomatic HF. We surmised that adipokines play a role in the relationships of menopausal age with cardiac structure and function and subsequently with clinical HF. The overarching goals of this proposal are to examine the influence of serum adipokines on the associations of menopausal age with cardiac structure and function measured by magnetic resonance imaging (MRI) in the Multi-Ethnic Study of Atherosclerosis (MESA). We will also investigate the moderating role of adipokines on the relationship between menopausal age and HF incidence (including HF subtypes), accounting for years post menopause, sex hormone levels and body composition using the MESA data. MESA provides a comprehensive assessment of body composition including body mass index, waist circumference, waist hip ratio, computed tomography measures of subcutaneous adipose tissue and visceral adipose tissue, sex hormone and adipokine data, detailed measures of cardiac structure and function by MRI and incident HF records. This approach illustrates the pathophysiological progression from subclinical cardiac dysfunction to clinical HF. MESA has information on preserved and reduced ejection fraction HF, further allowing us to explore associations according to HF subtypes. The results from this study will be used as pilot data for a future R01 grant aimed at further characterizing HF in postmenopausal women.