Department of Molecular and Genetic Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.
Cardiovasc Diabetol. 2009 Nov 18;8:60. doi: 10.1186/1475-2840-8-60.
Resistin, secreted from adipocytes, causes insulin resistance in mice. The relationship between resistin and coronary artery disease is highly controversial, and the information regarding resistin and ischemic stroke is limited. In the present study, the association between serum resistin concentration and cardiovascular disease (CVD) was investigated in a general Japanese population.
A total of 3,201 community-dwelling individuals aged 40 years or older (1,382 men and 1,819 women) were divided into quintiles of serum resistin, and the association between resistin and CVD was examined cross-sectionally. The combined effect of either diabetes or hypertension and high serum resistin was also assessed. Serum resistin was measured using ELISA.
Compared to those without CVD, age- and sex-adjusted mean serum resistin concentrations were greater in subjects with CVD (p = 0.002) or ischemic stroke (p < 0.001), especially in those with lacunar and atherothrombotic infarction, but not elevated in subjects with hemorrhagic stroke or coronary heart disease. When analyzed by quintile of serum resistin concentration, the age- and sex-adjusted odds ratio (OR) for having CVD and ischemic stroke increased with quintile of serum resistin (p for trends, 0.02 for CVD, < 0.001 for ischemic stroke), while such associations were not observed for hemorrhagic stroke or coronary heart disease. Compared to the first quintile, the age- and sex-adjusted OR of ischemic stroke was greater in the third (OR = 3.54; 95% confidence interval [CI], 1.17-10.67; p = 0.02), fourth (OR = 4.48; 95% CI, 1.53-13.09; p = 0.006), and fifth quintiles (OR = 4.70; 95% CI, 1.62-13.61; p = 0.004). These associations remained substantially unchanged even after adjustment for other confounding factors including high-sensitivity C-reactive protein. In the stratified analysis, the combination of high serum resistin and either diabetes or hypertension markedly increased the risk of ischemic stroke.
Elevated serum resistin concentration appears to be an independent risk factor for ischemic stroke, especially lacunar and atherothrombotic infarction in the general Japanese population. The combination of high resistin and the presence of either diabetes or hypertension increased the risk of ischemic stroke.
抵抗素是脂肪细胞分泌的一种蛋白，它会导致小鼠胰岛素抵抗。抵抗素与冠状动脉疾病之间的关系存在很大争议，而关于抵抗素与缺血性脑卒中的信息则较为有限。本研究旨在探讨一般日本人群血清抵抗素浓度与心血管疾病（CVD）之间的关系。
本研究共纳入了 3201 名年龄在 40 岁及以上的社区居民（男性 1382 名，女性 1819 名），按照血清抵抗素浓度的五分位数进行分组，采用横断面研究方法分析了抵抗素与 CVD 的关系。同时还评估了糖尿病或高血压与高血清抵抗素联合作用对缺血性脑卒中的影响。采用 ELISA 法检测血清抵抗素水平。
与无 CVD 的人群相比，CVD 患者（p = 0.002）或缺血性脑卒中患者（p < 0.001）的血清抵抗素浓度明显升高，且年龄和性别校正后的平均血清抵抗素浓度也更高，尤其是腔隙性和动脉粥样硬化性梗死患者，但出血性脑卒中或冠心病患者的血清抵抗素浓度并未升高。按血清抵抗素浓度五分位进行分析时，CVD 和缺血性脑卒中的年龄和性别校正比值比（OR）随血清抵抗素五分位的升高而增加（p 趋势值分别为 0.02 和 < 0.001），但与出血性脑卒中或冠心病无关。与第一五分位相比，第三（OR = 3.54；95%置信区间 [CI]，1.17-10.67；p = 0.02）、第四（OR = 4.48；95% CI，1.53-13.09；p = 0.006）和第五五分位（OR = 4.70；95% CI，1.62-13.61；p = 0.004）的缺血性脑卒中的年龄和性别校正 OR 更大。即使在校正其他混杂因素（包括高敏 C 反应蛋白）后，这些关联仍然基本保持不变。在分层分析中，高血清抵抗素与糖尿病或高血压的联合显著增加了缺血性脑卒中的风险。
血清抵抗素浓度升高似乎是日本普通人群发生缺血性脑卒中的一个独立危险因素，尤其是腔隙性和动脉粥样硬化性梗死。高抵抗素与糖尿病或高血压的存在相结合会增加缺血性脑卒中的风险。
