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

摘要 月经年龄是心力衰竭（HF）的性别特异性风险因素。尽管先前的研究表明 绝经年龄与亚临床心功能不全和HF的关系， 绝经年龄和心脏功能障碍尚不清楚。肥胖是一种已知的HF风险因素， 绝经后开始流行。脂肪因子，如瘦素和脂联素，它们是从 脂肪组织中的蛋白质与亚临床心功能不全和症状性HF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起作用， 随后出现临床HF。这项提案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的关系的磁共振测量 多种族动脉粥样硬化研究（梅萨）中的核磁共振成像（MRI）。我们还将调查 脂肪因子在绝经年龄和HF发病率（包括HF）之间的关系中的调节作用 亚型），占绝经后年数，性激素水平和身体成分使用梅萨 数据梅萨提供了一个全面的身体组成评估，包括身体质量指数，腰围， 腰围、腰臀比、皮下脂肪组织和内脏脂肪组织的计算机断层扫描测量 脂肪组织、性激素和脂肪因子数据，通过MRI详细测量心脏结构和功能 和事故高频记录这种方法说明了亚临床心脏病的病理生理进展， 临床HF的功能障碍。梅萨具有关于保留的和减少的射血分数HF的信息，进一步 使我们能够根据HF亚型探索相关性。这项研究的结果将作为试点 未来R01基金的数据旨在进一步表征绝经后妇女的HF。

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.