Hoefle G, Saely C H, Risch L, Rein P, Koch L, Schmid F, Aczél S, Marte T, Langer P, Drexel H
Academic Teaching Hospital, Feldkirch, Austria.
Eur J Clin Invest. 2007 Aug;37(8):629-36. doi: 10.1111/j.1365-2362.2007.01842.x.
The adipose tissue-related hormone leptin plays an important role in the regulation of body weight. The associations of leptin and leptin soluble receptor (sOb-R) with coronary artery disease (CAD) are not clear.
We measured leptin and sOb-R in 543 consecutive patients (379 men, 164 women) referred for coronary angiography for the evaluation of CAD. Coronary artery stenoses with lumen narrowing > or = 50% were considered significant.
Serum leptin correlated significantly with body mass index (r(s) = 0.443), with insulin resistance as assessed by the homeostasis model for the assessment of insulin resistance (r(s) = 0.339), with serum triglycerides (r(s) = 0.181), with systolic as well as diastolic blood pressure (r(s) = 0.170 and r(s) = 0.133, respectively) and, inversely, with sOb-R (r(s) = -0.346; P < 0.01 for all correlations). Coronary angiography revealed significant coronary artery stenoses in 331 (61%) of our patients. Serum leptin was significantly lower in patients with significant coronary artery stenoses than in patients without such lesions (8.5 +/- 7.8 vs. 13.2 +/- 12.2 ng mL(-1); P < 0.001). Multivariate logistic regression analysis proved serum leptin inversely and independently associated with the presence of significant coronary artery stenoses (standardized adjusted odds ratio 0.746, 95% confidence interval 0.566-0.983, P = 0.038). In contrast to serum concentrations of leptin, serum concentrations of sOb-R did not significantly differ between patients with significant stenoses and those without such lesions (22.4 +/- 8.3 vs. 23.1 +/- 12.1 ng mL(-1); P = 0.655).
Serum leptin but not sOb-R is significantly lower in patients with angiographically determined CAD. Despite its association with cardiovascular risk factors, leptin should not be simply regarded as a promoter of atherosclerosis.
脂肪组织相关激素瘦素在体重调节中起重要作用。瘦素及瘦素可溶性受体（sOb-R）与冠状动脉疾病（CAD）之间的关联尚不清楚。
我们对543例因评估CAD而接受冠状动脉造影的连续患者（379例男性，164例女性）进行了瘦素和sOb-R的测量。管腔狭窄≥50%的冠状动脉狭窄被视为显著狭窄。
血清瘦素与体重指数显著相关（r(s)=0.443），与通过稳态模型评估胰岛素抵抗所评估的胰岛素抵抗显著相关（r(s)=0.339），与血清甘油三酯显著相关（r(s)=0.181），与收缩压和舒张压均显著相关（分别为r(s)=0.170和r(s)=0.133），且与sOb-R呈负相关（r(s)=-0.346；所有相关性的P<0.01）。冠状动脉造影显示，我们的患者中有331例（61%）存在显著的冠状动脉狭窄。有显著冠状动脉狭窄的患者血清瘦素显著低于无此类病变的患者（8.5±7.8对13.2±12.2 ng/mL；P<0.001）。多因素逻辑回归分析证明血清瘦素与显著冠状动脉狭窄的存在呈负相关且独立相关（标准化调整优势比0.746，95%置信区间0.566-0.983，P=0.038）。与瘦素的血清浓度相反，有显著狭窄的患者与无此类病变的患者之间sOb-R的血清浓度无显著差异（22.4±8.3对23.1±12.1 ng/mL；P=0.655）。
经血管造影确定患有CAD的患者血清瘦素显著降低，而sOb-R无显著变化。尽管瘦素与心血管危险因素有关，但不应简单地将其视为动脉粥样硬化的促进因子。
