Rothenbacher Dietrich, Brenner Hermann, März Winfried, Koenig Wolfgang
Department of Epidemiology, The German Centre for Research on Ageing, University of Heidelberg, Germany.
Eur Heart J. 2005 Aug;26(16):1640-6. doi: 10.1093/eurheartj/ehi340. Epub 2005 Jun 2.
We investigated the association of serum adiponectin concentrations with the risk of coronary heart disease (CHD) after careful adjustment for other established risk factors. In addition, we investigated the association between adiponectin levels and established sociodemographic and laboratory risk markers for CHD.
Three hundred and twelve patients aged 40-68 with angiographically confirmed stable CHD and 476 age- and gender-matched controls were included in this case-control study. Adiponectin serum concentrations (adiponectin, R&D Systems, Wiesbaden, Germany), markers of inflammation and haemostasis, and an extensive lipid profile were determined. Adiponectin serum concentrations were lower in CHD patients when compared with age- and gender-matched controls, both in men (median 4.95 vs. 5.58 micromol/L, P=0.004) and in women (median 9.64 vs. 11.60 micromol/L, P=0.018). Adiponectin was strongly correlated with lipoproteins and apolipoproteins, in particular HDL-cholesterol (HDL-C), and to a lesser degree with markers of inflammation such as C-reactive protein, IL-6, or markers of coagulation or fibrinolysis. When compared with subjects with adiponectin serum concentrations in the lower quintile, the OR for CHD was 0.52 (95% CI 0.28-0.95) in the upper one after adjustment for covariates (P<0.007 for trend). After additional adjustment for HDL-C the association was strongly reduced, reflecting the close association between adiponectin and HDL-C.
Adiponectin serum concentrations may have an important role in the development of CHD. The protective effect of high serum concentration may partly be mediated by effects on the metabolism of lipoproteins, especially on the metabolism of HDL.
在对其他已确定的危险因素进行仔细校正后,我们研究了血清脂联素浓度与冠心病(CHD)风险之间的关联。此外,我们还研究了脂联素水平与已确定的冠心病社会人口统计学和实验室风险标志物之间的关联。
本病例对照研究纳入了312例年龄在40 - 68岁、经血管造影证实为稳定型冠心病的患者以及476例年龄和性别匹配的对照。测定了血清脂联素浓度(脂联素,R&D Systems,德国威斯巴登)、炎症和止血标志物以及广泛的血脂谱。与年龄和性别匹配的对照相比,冠心病患者的血清脂联素浓度较低,男性(中位数4.95对5.58 μmol/L,P = 0.004)和女性(中位数9.64对11.60 μmol/L,P = 0.018)均如此。脂联素与脂蛋白和载脂蛋白密切相关,尤其是高密度脂蛋白胆固醇(HDL-C),与炎症标志物如C反应蛋白、IL - 6或凝血或纤维蛋白溶解标志物的相关性较小。与血清脂联素浓度处于最低五分位数的受试者相比,校正协变量后,最高五分位数受试者患冠心病的OR为0.52(95% CI 0.28 - 0.95)(趋势P < 0.007)。在进一步校正HDL-C后,这种关联显著降低,反映了脂联素与HDL-C之间的密切关联。
血清脂联素浓度可能在冠心病的发生发展中起重要作用。高血清浓度的保护作用可能部分是通过对脂蛋白代谢的影响介导的,尤其是对HDL代谢的影响。