Matsushita Kunihiro, Yatsuya Hiroshi, Tamakoshi Koji, Wada Keiko, Otsuka Rei, Takefuji Seiko, Sugiura Kaichiro, Kondo Takahisa, Murohara Toyoaki, Toyoshima Hideaki
Department of Cardiology, Nagoya University Graduate School of Medicine, Japan.
Arterioscler Thromb Vasc Biol. 2006 Apr;26(4):871-6. doi: 10.1161/01.ATV.0000208363.85388.8f. Epub 2006 Feb 2.
Anti-inflammatory and proinflammatory molecules purportedly play an important role in developing metabolic syndrome (MetS). However, little is known as to the relative importance of these molecules in the association with MetS.
We studied 624 middle-aged Japanese men without medical history of cardiovascular disease or cancer and investigated the associations of circulating tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), C-reactive protein (CRP), and adiponectin with MetS. We used the respective definitions proposed by the National Cholesterol Education Program Adult Treatment Panel III (ATP-III), the International Diabetes Federation, and the Japanese Society of Internal Medicine. Decreased serum adiponectin was observed in those with any of the ATP-III-MetS components, whereas this was not the case with increased TNF-alpha, IL-6, or CRP. Adiponectin and CRP levels linearly deteriorated with an increasing number of ATP-III-MetS components (trend P<0.001, respectively). Significantly higher CRP and lower adiponectin levels were observed in those who met any MetS criteria, whereas increased TNF-alpha was observed in only those with ATP-III-MetS. Finally, odds ratios (ORs) for MetS prevalence of a 1-SD increase/decrease in log-transformed 4 markers were calculated with multivariate logistic regression analyses. Consequently, decreased adiponectin was associated most strongly with ATP-III-MetS (adiponectin: OR, 1.90 [95% CI, 1.44 to 2.51]; P<0.001; CRP: OR, 1.33 [95% CI, 1.01 to 1.74]; P=0.03; TNF-alpha: OR, 1.25 [95% CI, 0.94 to 1.67]; P=0.12; and IL-6: OR, 0.87 [95% CI, 0.63 to 1.19]; P=0.37). This result was not altered by using the other 2 criteria.
The present results raise the possibility that decreased serum adiponectin might be fundamentally involved in the development of MetS.
抗炎和促炎分子据称在代谢综合征（MetS）的发生发展中起重要作用。然而，这些分子在与MetS关联中的相对重要性却知之甚少。
我们研究了624名无心血管疾病或癌症病史的中年日本男性，调查了循环肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、C反应蛋白（CRP）和脂联素与MetS的关联。我们采用了美国国家胆固醇教育计划成人治疗小组第三次报告（ATP-III）、国际糖尿病联盟和日本内科医学会提出的各自定义。在患有任何ATP-III-MetS组分的患者中观察到血清脂联素降低，而TNF-α、IL-6或CRP升高的情况并非如此。脂联素和CRP水平随着ATP-III-MetS组分数量的增加呈线性恶化（趋势P<0.001）。在符合任何MetS标准的患者中观察到CRP显著升高和脂联素水平降低，而仅在患有ATP-III-MetS的患者中观察到TNF-α升高。最后用多因素逻辑回归分析计算4种标志物对数转换后每增加/降低1个标准差时MetS患病率的比值比（OR）。结果显示，脂联素降低与ATP-III-MetS的关联最为密切（脂联素：OR，1.90 [95%CI，1.44至2.51]；P<0.001；CRP：OR，1.33 [95%CI，1.01至1.74]；P=0.03；TNF-α：OR，1.25 [95%CI，0.94至1.67]；P=0.12；IL-6：OR，0.87 [95%CI，0.63至1.19]；P=0.37）。使用其他2种标准时该结果未改变。
目前的结果提示血清脂联素降低可能从根本上参与了MetS的发生发展。
