Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Stroke. 2010 Jul;41(7):1376-81. doi: 10.1161/STROKEAHA.109.576546. Epub 2010 May 27.
Although low levels of adiponectin are associated with coronary heart disease and cardiovascular disease risk factors, it is unclear whether adiponectin levels are related to the risk of developing ischemic stroke.
We examined the relationship between baseline high-molecular-weight (HMW) adiponectin levels and incident ischemic stroke in postmenopausal women using data and specimens from the Hormones and Biomarkers Predicting Stroke Study, a case-control study nested within the Women's Health Initiative Observational Study. Included were 855 incident ischemic stroke cases and 855 control subjects matched for age, race-ethnicity, date of entry into the cohort, and follow-up time. ORs of incident ischemic stroke associated with baseline HMW adiponectin levels were calculated using conditional logistic regression modeling adjusting for body mass index, type 2 diabetes, hypertension, smoking, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, physical activity, C-reactive protein, and aspirin use.
Lower levels of HMW adiponectin were significantly associated with type 2 diabetes, hypertension, higher body mass index, waist circumference, glucose, and insulin levels and lower high-density lipoprotein cholesterol levels. The distribution of incident stroke cases by HMW adiponectin quartiles was 49.9%, 50.5%, 50.7%, and 48.9%, respectively (P=0.96). Multivariable-adjusted ORs of stroke associated with the top 3 quartiles of HMW adiponectin versus the first quartile were 0.99 (95% CI, 0.71 to 1.37), 1.37 (0.99 to 1.91), and 1.25 (0.88 to 1.79), respectively (P trend=0.14).
Despite moderate associations between HMW adiponectin and cardiovascular disease risk factors, we found no evidence of an association between HMW adiponectin levels and incident ischemic stroke in these postmenopausal women.
尽管脂联素水平较低与冠心病和心血管疾病危险因素有关,但脂联素水平是否与发生缺血性卒中的风险有关尚不清楚。
我们利用激素和生物标志物预测卒中研究的数据和标本(该研究嵌套于妇女健康倡议观察性研究中),在绝经后妇女中检验了基线高分子量(HMW)脂联素水平与新发缺血性卒中之间的关系。共纳入 855 例新发缺血性卒中病例和 855 例年龄、种族、入组队列日期和随访时间相匹配的对照。采用条件 logistic 回归模型,在校正体重指数、2 型糖尿病、高血压、吸烟、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、体力活动、C 反应蛋白和阿司匹林使用情况后,计算与基线 HMW 脂联素水平相关的新发缺血性卒中的比值比(OR)。
HMW 脂联素水平较低与 2 型糖尿病、高血压、更高的体重指数、腰围、血糖和胰岛素水平以及更低的高密度脂蛋白胆固醇水平显著相关。按 HMW 脂联素四分位数分布的新发卒中病例数分别为 49.9%、50.5%、50.7%和 48.9%(P=0.96)。与 HMW 脂联素四分位区间的第 1 个四分位相比,第 2、第 3 和第 4 个四分位的 HMW 脂联素水平与卒中相关的多变量校正 OR 分别为 0.99(95%CI,0.71 至 1.37)、1.37(0.99 至 1.91)和 1.25(0.88 至 1.79)(P 趋势=0.14)。
尽管 HMW 脂联素与心血管疾病危险因素之间存在中度关联,但我们在这些绝经后妇女中未发现 HMW 脂联素水平与新发缺血性卒中之间存在关联。