Lawlor Debbie A, Smith George Davey, Kelly Anne, Sattar Naveed, Ebrahim Shah
Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK.
Obesity (Silver Spring). 2007 Jul;15(7):1694-701. doi: 10.1038/oby.2007.202.
Prospective studies have shown a positive association between leptin concentrations and coronary heart disease (CHD) in men, but its effect in women is unclear. Our objective was to examine the association of serum leptin levels with CHD in a prospective study of women.
We conducted a prospective (4 year) case (N=165) control (N=335) study nested within a cohort of 4286 British women.
With mutual adjustment for each other and age, social class, smoking, and physical activity, leptin was positively associated with BMI, fasting insulin, total cholesterol, low-density lipoprotein-cholesterol, triglycerides, and hypertension and was inversely associated with homeostasis model assessment insulin sensitivity. Leptin was not associated with CHD risk (age-adjusted relative risk for a doubling of leptin: 1.08 [95% confidence interval (CI): 0.91, 1.29]). This changed little with adjustment for childhood and adult social class, smoking, alcohol, and physical activity but attenuated to 1.00 (95% CI: 0.80, 1.26) with further adjustment for other metabolic risk factors (waist-to-hip ratio, low-density lipoprotein-cholesterol, triglycerides, C-reactive protein, fasting insulin, hypertension).
We found no strong statistical evidence that leptin is associated with CHD risk in this study population of older British women. Further research is needed to compare associations of leptin with CHD in men and women and to determine whether the effect varies by gender.
前瞻性研究表明,男性瘦素浓度与冠心病(CHD)之间存在正相关,但在女性中的作用尚不清楚。我们的目的是在一项针对女性的前瞻性研究中,检验血清瘦素水平与冠心病的关联。
我们在一个由4286名英国女性组成的队列中进行了一项前瞻性(4年)病例对照研究(病例组N = 165,对照组N = 335)。
在相互调整以及调整年龄、社会阶层、吸烟和身体活动后,瘦素与体重指数、空腹胰岛素、总胆固醇、低密度脂蛋白胆固醇、甘油三酯和高血压呈正相关,与稳态模型评估胰岛素敏感性呈负相关。瘦素与冠心病风险无关(瘦素翻倍时年龄调整后的相对风险:1.08 [95%置信区间(CI):0.91,1.29])。在调整儿童期和成年期社会阶层、吸烟、饮酒和身体活动后,这一结果变化不大,但在进一步调整其他代谢风险因素(腰臀比、低密度脂蛋白胆固醇、甘油三酯、C反应蛋白、空腹胰岛素、高血压)后,该结果减弱至1.00(95% CI:0.80,1.26)。
在这个老年英国女性研究人群中,我们没有发现强有力的统计学证据表明瘦素与冠心病风险相关。需要进一步研究以比较男性和女性中瘦素与冠心病的关联,并确定这种效应是否因性别而异。