Costacou Tina, Bosnyak Zsolt, Harger Gail F, Markovic Nina, Silvers Nancy, Orchard Trevor J
University of Pittsburgh, Department of Epidemiology, Pittsburgh, PA 15213, USA.
Prev Cardiol. 2008 Spring;11(2):106-15. doi: 10.1111/j.1751-7141.2008.07512.x.
The authors compared postpartum adiponectin levels among women with prior pregnancy-induced disturbances and assessed their association with homeostasis model assessment for insulin resistance (HOMA-IR), the metabolic syndrome (MS), and the Framingham risk score (FRS). Women delivering in 1998 through 2001 and who had gestational diabetes mellitus (n=22), gestational hypertension (n=32), or preeclampsia (n=34) were examined 1 to 2 years after delivery and were grouped-matched to controls (n=29) by age and prepregnancy body mass index. HOMA-IR was increased, adiponectin values were decreased, and there was a higher MS prevalence in women with prior gestational diabetes mellitus (all P<.05). Adiponectin levels were inversely related to HOMA-IR (r=-0.45; P<.0001) and FRS (r=-0.25; P=.007), and a significant trend for decreasing adiponectin values with increased number of MS components was noted (P trend <.0001). Adiponectin concentration remained a significant correlate of FRS and MS irrespective of pregnancy history; a concentration <10.5 microg/mL provided the optimal cutoff to distinguish those with or without MS. Thus, a lower postpartum adiponectin concentration identifies women at increased cardiovascular risk regardless of pregnancy history.
作者比较了既往有妊娠相关疾病的女性产后脂联素水平，并评估了其与胰岛素抵抗稳态模型评估（HOMA-IR）、代谢综合征（MS）及弗雷明汉风险评分（FRS）之间的关联。对1998年至2001年间分娩且患有妊娠期糖尿病（n=22）、妊娠期高血压（n=32）或先兆子痫（n=34）的女性在产后1至2年进行检查，并根据年龄和孕前体重指数将她们与对照组（n=29）进行分组匹配。既往有妊娠期糖尿病的女性HOMA-IR升高，脂联素值降低，且MS患病率更高（所有P<.05）。脂联素水平与HOMA-IR（r=-0.45；P<.0001）及FRS（r=-0.25；P=.007）呈负相关，并且随着MS组分数量增加，脂联素值有显著下降趋势（P趋势<.0001）。无论妊娠史如何，脂联素浓度仍然是FRS和MS的显著相关因素；浓度<10.5μg/mL可作为区分有无MS的最佳临界值。因此，无论妊娠史如何，产后脂联素浓度较低均表明女性心血管疾病风险增加。
