Mitsuhashi Hirotsugu, Yatsuya Hiroshi, Tamakoshi Koji, Matsushita Kunihiro, Otsuka Rei, Wada Keiko, Sugiura Kaichiro, Takefuji Seiko, Hotta Yo, Kondo Takahisa, Murohara Toyoaki, Toyoshima Hideaki
Department of Public Health/Health Information Dynamics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
Hypertension. 2007 Jun;49(6):1448-54. doi: 10.1161/HYPERTENSIONAHA.106.079509. Epub 2007 Apr 9.
A recent study has demonstrated that adiponectin inhibited hypertrophic signaling in the myocardium of mice, implying that a decrease in the blood adiponectin level could cause cardiac muscle hypertrophy. We hypothesized that a relationship might exist between the serum adiponectin level and electrocardiographically diagnosed left ventricular hypertrophy (ECG-LVH), and we examined this hypothesis by epidemiological study of 2839 Japanese male workers who were not taking medications for hypertension. ECG-LVH was defined as meeting Sokolow-Lyon voltage criteria and/or Cornell voltage-duration product. The subjects were categorized by tertiles of serum adiponectin level, and a multivariate logistic regression analysis was conducted relating left ventricular hypertrophy to adiponectin tertiles adjusting for potential confounding factors. Prevalence of ECG-LVH in the studied sample was 16.7%. Adiponectin ranged from 1.0 to 5.0 microg/mL in the lowest category and from 7.4 to 30.6 microg/mL in the highest. Compared with subjects in the highest adiponectin category, those in the lowest one had a significantly higher prevalence of ECG-LVH independent of age, body mass index, and systolic blood pressure with an odds ratio of 1.50 and a 95% CI of 1.16 to 1.94. Further adjustment for high-density lipoprotein cholesterol, triglyceride, and insulin resistance did not change the association (odds ratio: 1.68; 95% CI: 1.28 to 2.21; P<0.001). Similar results were obtained when different criteria for ECG-LVH were used or when subjects were stratified by blood pressure or body mass index. Adiponectin concentration was inversely and independently associated with ECG-LVH in Japanese men.
最近的一项研究表明,脂联素可抑制小鼠心肌中的肥厚信号传导,这意味着血液中脂联素水平的降低可能导致心肌肥厚。我们推测血清脂联素水平与心电图诊断的左心室肥厚(ECG-LVH)之间可能存在关联,并通过对2839名未服用抗高血压药物的日本男性工人进行流行病学研究来检验这一假设。ECG-LVH的定义为符合索科洛-里昂电压标准和/或康奈尔电压-持续时间乘积。根据血清脂联素水平的三分位数对受试者进行分类,并进行多变量逻辑回归分析,将左心室肥厚与脂联素三分位数相关联,并对潜在的混杂因素进行调整。研究样本中ECG-LVH的患病率为16.7%。脂联素在最低类别中范围为1.0至5.0微克/毫升,在最高类别中为7.4至30.6微克/毫升。与脂联素最高类别的受试者相比,最低类别的受试者ECG-LVH的患病率显著更高,独立于年龄、体重指数和收缩压,优势比为1.50,95%置信区间为1.16至1.94。进一步调整高密度脂蛋白胆固醇、甘油三酯和胰岛素抵抗后,这种关联没有改变(优势比:1.68;95%置信区间:1.28至2.21;P<0.001)。当使用不同的ECG-LVH标准或根据血压或体重指数对受试者进行分层时,也得到了类似的结果。在日本男性中,脂联素浓度与ECG-LVH呈负相关且独立相关。