Department of Internal Medicine, Central Hospital, 652 30 Karlstad, Sweden.
Diabetes Metab. 2010 Apr;36(2):137-43. doi: 10.1016/j.diabet.2009.10.004. Epub 2010 Feb 12.
Plasma total adiponectin is a marker of insulin resistance, but its role in predicting cardiovascular events is unclear. We aimed to investigate the role of adiponectin as a predictor of cardiovascular risk in middle-aged men, and to describe the association between adiponectin and glucose metabolism.
In this population-based prospective study of middle-aged men (n=3885), total adiponectin was analyzed. All individuals had undergone an oral glucose tolerance test (OGTTs), and the mean follow-up duration was 27 years. Regression analyses were carried out for indices of glucose metabolism in relation to quintiles (Q1-Q5) of total adiponectin levels. After stratification for smoking or not, the association between total adiponectin and the first incidence of fatal or non-fatal cardiovascular disease (CVD) was analyzed, using Cox's proportional-hazards regression model.
In a separate multiple-regression analysis and after adjusting for possible confounders, the relationship between adiponectin levels and markers of glucose metabolism were found to be significant (P<0.05). However, adiponectin did not independently predict the risk of stroke, coronary events, or a combination of these two outcomes.
Levels of total plasma adiponectin are not useful for predicting long-term cardiovascular events in middle-aged men, but are strongly associated with glucose metabolism and markers of insulin resistance.
血浆总脂联素是胰岛素抵抗的标志物，但它在预测心血管事件中的作用尚不清楚。我们旨在研究脂联素作为中年男性心血管风险预测因子的作用，并描述脂联素与葡萄糖代谢之间的关系。
在这项针对中年男性（n=3885）的基于人群的前瞻性研究中，分析了总脂联素。所有个体均进行了口服葡萄糖耐量试验（OGTTs），平均随访时间为 27 年。针对总脂联素水平的五分位数（Q1-Q5），进行了关于葡萄糖代谢指标的回归分析。在按是否吸烟分层后，使用 Cox 比例风险回归模型分析了总脂联素与致命或非致命性心血管疾病（CVD）首次发病之间的关系。
在单独的多元回归分析中，并在调整了可能的混杂因素后，发现脂联素水平与葡萄糖代谢标志物之间存在显著关系（P<0.05）。然而，脂联素并不能独立预测中风、冠状动脉事件或这两种结果的组合风险。
血浆总脂联素水平不能用于预测中年男性的长期心血管事件，但与葡萄糖代谢和胰岛素抵抗标志物密切相关。
