Vascular Research Unit, Department of Vascular Surgery, Viborg Hospital, Denmark.
Atherosclerosis. 2010 Jun;210(2):619-24. doi: 10.1016/j.atherosclerosis.2009.12.030. Epub 2010 Jan 4.
Adiponectin exerts anti-atherogenic and anti-inflammatory properties and may be important as a biomarker for cardiovascular disease (CVD). We examined whether serum adiponectin was linked with future cardiovascular events or all-cause death in patients with peripheral arterial disease (PAD).
The study prospectively included 468 patients (58% male) with symptomatic PAD. Serum total adiponectin was determined by an in-house immunoassay. We used Cox regression, adjusted for age, gender, BMI, systemic hypertension, smoking status, diabetes mellitus, previous myocardial infarction (MI), ankle-brachial index (ABI), symptoms of leg ischemia, total cholesterol, and use of beta-blockers (BAB) and angiotensin-converting enzyme (ACE) inhibitors to assess possible relationship between serum adiponectin and time to first non-fatal cardiovascular event, and all-cause death.
During the median follow-up of 3.5 years, 215 new cases of non-fatal cardiovascular events and 97 all-cause deaths were detected. Adjusted Cox-regression analysis showed that a 1mg/l increase in serum adiponectin was associated with a decrease in the risk of non-fatal cardiovascular events to 0.68, (95% CI 0.47-0.99) in men, but not in women (HR 0.96 95% CI 0.55-1.70). The relative risk of adverse non-fatal cardiovascular events was 77% higher in male patients within the lower adiponectin tertile, when compared with those in the higher tertile (95% CI 1.05-2.97). Moreover, serum adiponectin was the only significant independent predictor of non-fatal cardiovascular events for men with severe PAD (HR=0.37, 95% CI, 0.16-0.89; p=0.026), whereas previous MI (p=0.92) and ABI (p=0.08) failed to reach statistical significance in the multivariable model. We did not obtain any significant associations between serum adiponectin and all-cause mortality. Multivariable model revealed that age and previous MI were independently associated with risk for all-cause death.
Lower levels of serum adiponectin were significantly associated with an increased risk for future non-fatal cardiovascular events in men with symptomatic PAD, but not in women.
脂联素具有抗动脉粥样硬化和抗炎作用，可作为心血管疾病（CVD）的生物标志物。我们研究了血清脂联素与外周动脉疾病（PAD）患者未来心血管事件或全因死亡之间的关系。
这项前瞻性研究纳入了 468 例（58%为男性）有症状的 PAD 患者。采用内部免疫测定法测定血清总脂联素。我们使用 Cox 回归，调整了年龄、性别、BMI、系统性高血压、吸烟状况、糖尿病、既往心肌梗死（MI）、踝肱指数（ABI）、腿部缺血症状、总胆固醇和β受体阻滞剂（BAB）和血管紧张素转换酶（ACE）抑制剂的使用情况，以评估血清脂联素与首次非致命性心血管事件和全因死亡之间的时间的可能关系。
在中位数为 3.5 年的随访期间，检测到 215 例非致命性心血管事件和 97 例全因死亡。调整后的 Cox 回归分析显示，血清脂联素每增加 1mg/L，男性发生非致命性心血管事件的风险降低至 0.68（95%CI 0.47-0.99），但女性无此关联（HR 0.96，95%CI 0.55-1.70）。与脂联素较高三分位组相比，脂联素较低三分位组的男性患者发生不良非致命性心血管事件的相对风险增加了 77%（95%CI 1.05-2.97）。此外，血清脂联素是严重 PAD 男性患者非致命性心血管事件的唯一显著独立预测因子（HR=0.37，95%CI，0.16-0.89；p=0.026），而既往 MI（p=0.92）和 ABI（p=0.08）在多变量模型中未达到统计学意义。我们未发现血清脂联素与全因死亡率之间存在任何显著关联。多变量模型显示，年龄和既往 MI 与全因死亡风险独立相关。
血清脂联素水平较低与有症状的 PAD 男性患者未来非致命性心血管事件风险增加显著相关，但在女性中无此关联。
