Morehouse School of Medicine, Atlanta, GA 30310, USA.
Circ Heart Fail. 2011 Nov;4(6):747-53. doi: 10.1161/CIRCHEARTFAILURE.110.959742. Epub 2011 Aug 12.
Blacks have a higher prevalence of left ventricular hypertrophy than whites. Several population-based studies have reported an inverse association between adiponectin and left ventricular mass (LVM); however, the relationship between adiponectin levels and LVM has yet to be defined in blacks. The Jackson Heart Study cohort provides an opportunity to test the hypothesis that the inverse association between adiponectin and LVM may be modified by risk factors common among blacks.
The study population included 2649 black Jackson Heart Study participants (mean age 51±12 years, 63% women, 51% obese, 54% with hypertension, and 16% with diabetes). Multiple linear and spline regression was used to assess the association, with adjustment for demographic, clinical, and behavioral covariates. Among all the participants, there was a statistically significant but modest inverse association between adiponectin and LVM index. Hypertension and insulin resistance emerged as statistically significant effect modifiers of this relationship. The inverse association present among the normotensive participants was explained by obesity measures such as the body mass index. Among participants with both hypertension and insulin resistance, there was a significant direct association between adiponectin and the LVM index after multivariable adjustment (β=1.55, P=0.04, per 1-SD increment in the adiponectin log value).
The association between serum adiponectin and LVM among blacks in the Jackson Heart Study cohort was dependent on hypertension and insulin resistance status. Normotensive blacks exhibited an inverse adiponectin-LVM association, whereas participants with hypertension and insulin resistance had a direct association.
黑人左心室肥厚的患病率高于白人。几项基于人群的研究报告称,脂联素与左心室质量(LVM)之间呈负相关;然而,脂联素水平与 LVM 之间的关系尚未在黑人中确定。杰克逊心脏研究队列提供了一个机会,可以检验这样一个假设,即脂联素与 LVM 之间的负相关可能会被黑人常见的危险因素所改变。
研究人群包括 2649 名黑人杰克逊心脏研究参与者(平均年龄 51±12 岁,63%为女性,51%肥胖,54%患有高血压,16%患有糖尿病)。采用多元线性和样条回归来评估相关性,并调整人口统计学、临床和行为协变量。在所有参与者中,脂联素与 LVM 指数之间存在统计学上显著但适度的负相关。高血压和胰岛素抵抗是这种关系的统计学上显著的效应修饰因子。在正常血压参与者中存在的负相关关系可以通过肥胖指标如体重指数来解释。在同时患有高血压和胰岛素抵抗的参与者中,经过多变量调整后,脂联素与 LVM 指数之间存在显著的直接关联(β=1.55,P=0.04,每增加 1-SD 脂联素对数值)。
在杰克逊心脏研究队列中,黑人血清脂联素与 LVM 之间的相关性取决于高血压和胰岛素抵抗状态。正常血压的黑人表现出脂联素-LVM 的负相关关系,而患有高血压和胰岛素抵抗的参与者则存在直接的关联。