Koenig Wolfgang, Khuseyinova Natalie, Baumert Jens, Meisinger Christa, Löwel Hannelore
Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, Ulm, Germany.
J Am Coll Cardiol. 2006 Oct 3;48(7):1369-77. doi: 10.1016/j.jacc.2006.06.053. Epub 2006 Sep 12.
We sought to assess the association between serum concentrations of adiponectin and long-term risk of type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD) in initially healthy middle-aged men within the same representative population in Augsburg, southern Germany.
It has been postulated that high serum concentrations of adiponectin, an emerging biomarker that is linked to insulin resistance and endothelial dysfunction, may be protective against T2DM and CHD.
Serum concentrations of adiponectin were determined in apparently healthy middle-aged men, sampled from the general population in 1984/1985 and followed until 2002. During this period, 115 of 887 men had a newly diagnosed T2DM, and 126 of 937 men suffered from a CHD event.
In a Cox model, after multivariable adjustment for cardiovascular risk factors, the hazard ratio of incident T2DM, comparing extreme tertiles of the adiponectin distribution, was 0.55 (95% confidence interval [CI], 0.35 to 0.89), and for incident CHD it was 0.62 (95% CI, 0.39 to 0.98). Further adjustment for high-density lipoprotein cholesterol (HDL-C) attenuated the association, which became formally non-significant. In joint analysis, men with low adiponectin and low HDL-C values showed a 2.63 times (95% CI, 1.66 to 4.15) increased incidence of T2DM and a 1.91 times (95% CI, 1.20 to 3.04) increased incidence of CHD after multivariable adjustment in comparison with men with high HDL-C and high adiponectin.
For patients with low HDL-C values, additional measurement of adiponectin may be helpful to identify individuals at very high risk for T2DM and CHD.
我们试图评估德国南部奥格斯堡同一代表性人群中，初始健康的中年男性血清脂联素浓度与2型糖尿病（T2DM）和冠心病（CHD）长期风险之间的关联。
有假设认为，脂联素是一种与胰岛素抵抗和内皮功能障碍相关的新兴生物标志物，高血清脂联素浓度可能对T2DM和CHD具有保护作用。
测定了1984/1985年从普通人群中抽取的表面健康中年男性的血清脂联素浓度，并随访至2002年。在此期间，887名男性中有115人新诊断为T2DM，937名男性中有126人发生CHD事件。
在Cox模型中，对心血管危险因素进行多变量调整后，比较脂联素分布的极端三分位数时，T2DM发病的风险比为0.55（95%置信区间[CI]，0.35至0.89），CHD发病的风险比为0.62（95%CI，0.39至0.98）。进一步调整高密度脂蛋白胆固醇（HDL-C）后，这种关联减弱，在统计学上不再显著。在联合分析中，与HDL-C和脂联素水平高的男性相比，多变量调整后，脂联素和HDL-C水平低的男性T2DM发病率增加2.63倍（95%CI，1.66至4.15），CHD发病率增加1.91倍（95%CI，1.20至3.04）。
对于HDL-C水平低的患者，额外检测脂联素可能有助于识别T2DM和CHD极高风险个体。
