Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Clin Endocrinol (Oxf). 2012 Sep;77(3):370-8. doi: 10.1111/j.1365-2265.2011.04260.x.
To systematically evaluate low serum adiponectin level as a risk factor for cardiovascular disease (CVD). A meta-analysis was performed to quantitatively analyse the association of serum total adiponectin level with CVD using previous case-control studies in Han Chinese populations.
Several electronic databases were searched for relevant articles up to July 2011. A total of nine (n = 933), eight (n = 939) articles were included in each meta-analysis regarding the association of serum adiponectin level with coronary heart disease (CHD) and ischaemic stroke, respectively. Publication bias was examined by the Egger's linear regression test. Sensitivity analysis was performed by omitting one study at a time, and the pooled standardized mean difference (SMD) was estimated using fixed-effects model and random-effects model, respectively.
Serum total adiponectin concentrations were lower in patients with CHD and ischaemic stroke, with pooled SMD of -1·41 (95% CI -1·69, -1·12, P < 0·00001) and -1·69 (95% CI -2·04, -1·33, P < 0·00001), respectively. By performing a meta-regression analysis, homeostasis model assessment of insulin resistance, study size, adiponectin measurement assays, gender and mean body mass index of cases failed to account for heterogeneity for comparisons between lower adiponectin level and ischaemic stroke. However, study size had significant effect on the association of lower adiponectin level with CHD and accounted for 96·72% of the between-study variance. No publication bias was detected. No single study was found to affect the overall result of each analysis by sensitivity testing.
The accumulated evidence suggested that low serum adiponectin level increased the risk of a first cardiovascular event in the Han Chinese population. Further study is recommended with larger sample size to explore the role of hypoadiponectinemia in the causation of CVD.
系统评估低血清脂联素水平作为心血管疾病（CVD）的危险因素。采用荟萃分析定量分析汉族人群中血清总脂联素水平与 CVD 的相关性。
检索了截至 2011 年 7 月的相关文献电子数据库。共有 9 项（n = 933）和 8 项（n = 939）研究分别纳入了血清脂联素水平与冠心病（CHD）和缺血性卒中的荟萃分析。采用 Egger 线性回归检验评估发表偏倚。通过依次剔除一项研究进行敏感性分析，分别采用固定效应模型和随机效应模型估计合并标准化均数差（SMD）。
CHD 和缺血性卒中患者的血清总脂联素浓度均较低，合并 SMD 分别为-1.41（95%CI-1.69，-1.12，P<0.00001）和-1.69（95%CI-2.04，-1.33，P<0.00001）。通过进行荟萃回归分析，胰岛素抵抗评估的稳态模型、研究规模、脂联素测定方法、性别和病例的平均体重指数未能解释低脂联素水平与缺血性卒中之间的异质性。然而，研究规模对低脂联素水平与 CHD 的相关性有显著影响，占研究间变异的 96.72%。未发现发表偏倚。敏感性分析发现，没有单个研究对每项分析的总体结果产生影响。
累积证据表明，低血清脂联素水平增加了汉族人群首次心血管事件的风险。建议进行更大样本量的进一步研究，以探讨低脂联素血症在 CVD 发病机制中的作用。
