Frystyk Jan, Berne Christian, Berglund Lars, Jensevik Karin, Flyvbjerg Allan, Zethelius Björn
Medical Research Laboratories, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark.
J Clin Endocrinol Metab. 2007 Feb;92(2):571-6. doi: 10.1210/jc.2006-1067. Epub 2006 Nov 21.
Cross-sectional and nested case-control studies indicate a relationship between adiponectin, obesity, and coronary heart disease (CHD).
Our objective was to investigate whether adiponectin could predict CHD in a population-based cohort of elderly men.
From 1991-1995 a baseline investigation was carried out in 832 healthy men aged 70 yr in the Uppsala Longitudinal Study of Adult Men (ULSAM study). They were followed up to 10.4 yr using Swedish national registry data. The baseline investigation included anthropometry, blood pressure, smoking, serum lipids, a euglycemic insulin clamp, and fasting serum adiponectin.
Main outcome measures were defined as death or first-time hospitalization for CHD (n = 116), recorded in the Cause of Death Registry or in the Hospital-Discharge Registry of the National Board of Health and Welfare, Sweden. Associations were analyzed using Cox's proportional hazards regression, presented as hazard ratios (HR) with 95% confidence intervals (CI) for 1 sd increase in the predictor variable.
In a multivariable analysis including total cholesterol (HR, 1.24; CI, 1.02-1.50), high-density lipoprotein cholesterol (HR, 0.72; CI, 0.58-0.89), smoking (HR, 1.39; CI, 0.91-2.14), and systolic blood pressure (HR, 1.26; CI, 1.05-1.52), serum adiponectin was associated with lower risk for CHD (HR, 0.81; CI, 0.66-0.99). The association was independent of BMI and remained significant after adjustment for insulin sensitivity index.
In this population-based cohort of healthy men, elevated serum levels of adiponectin were associated with a lower risk for CHD. Importantly, the association between adiponectin and CHD was independent of other well-known risk factors.
横断面研究和巢式病例对照研究表明脂联素、肥胖与冠心病（CHD）之间存在关联。
我们的目的是调查在一个基于人群的老年男性队列中脂联素是否能够预测冠心病。
1991年至1995年期间，在乌普萨拉成年男性纵向研究（ULSAM研究）中，对832名70岁的健康男性进行了基线调查。利用瑞典国家登记数据对他们进行了长达10.4年的随访。基线调查包括人体测量、血压、吸烟情况、血脂、正常血糖胰岛素钳夹试验以及空腹血清脂联素。
主要观察指标定义为冠心病死亡或首次住院（n = 116），记录于瑞典国家卫生和福利委员会的死亡原因登记处或医院出院登记处。使用Cox比例风险回归分析关联，以预测变量每增加1个标准差的风险比（HR）及其95%置信区间（CI）表示。
在一项多变量分析中，纳入总胆固醇（HR，1.24；CI，1.02 - 1.50）、高密度脂蛋白胆固醇（HR，0.72；CI，0.58 - 0.89）、吸烟（HR，1.39；CI，0.91 - 2.14）和收缩压（HR，1.26；CI，1.05 - 1.52），血清脂联素与冠心病风险降低相关（HR，0.81；CI，0.66 - 0.99）。该关联独立于体重指数，在调整胰岛素敏感性指数后仍具有显著性。
在这个基于人群的健康男性队列中，血清脂联素水平升高与冠心病风险降低相关。重要的是，脂联素与冠心病之间的关联独立于其他众所周知的风险因素。
