Department of Cardiology, Nagoya University Graduate School of Medicine.
Circ J. 2013;77(11):2778-85. doi: 10.1253/circj.cj-13-0251. Epub 2013 Aug 6.
Low adiponectin levels and high leptin levels are associated with a high incidence of developing cardiovascular disease. However, the relationship between the levels of these adipokines and the development of adverse events after acute myocardial infarction (AMI) remains unclear.
This study enrolled 724 Japanese subjects with AMI who underwent successful emergency percutaneous coronary intervention (PCI). Their serum adiponectin and leptin levels were measured 7 days after AMI onset. There were 63 adverse events during the 3-year follow-up. The levels of adiponectin and leptin and the leptin to adiponectin ratio, were significantly associated with adverse events [hazard ratio 2.08 (95% confidence interval (CI) 1.33-3.24), P=0.001; hazard ratio 0.62 (95% CI 0.43-0.90), P=0.012; hazard ratio 0.59 (95% CI 0.45-0.76), P<0.001, respectively]. The leptin to adiponectin ratio remained a significant independent predictor of adverse events during long-term follow-up in a multivariable analysis [adjusted hazard ratio 0.60 (95% CI 0.43-0.83), P=0.002].
Higher adiponectin and lower leptin levels are associated with a high incidence of adverse events in Japanese patients after AMI, and the leptin to adiponectin ratio independently predicts prognosis after AMI.
低脂联素水平和高瘦素水平与心血管疾病发病率升高有关。然而，这些脂肪因子水平与急性心肌梗死（AMI）后不良事件的发展之间的关系尚不清楚。
本研究纳入了 724 例接受成功急诊经皮冠状动脉介入治疗（PCI）的日本 AMI 患者。在 AMI 发病后 7 天测量了他们的血清脂联素和瘦素水平。在 3 年的随访中有 63 例不良事件。脂联素和瘦素水平以及瘦素与脂联素的比值与不良事件显著相关[风险比 2.08（95%置信区间 1.33-3.24），P=0.001；风险比 0.62（95%置信区间 0.43-0.90），P=0.012；风险比 0.59（95%置信区间 0.45-0.76），P<0.001]。在多变量分析中，瘦素与脂联素的比值在长期随访中仍然是不良事件的独立预测因子[调整后的风险比 0.60（95%置信区间 0.43-0.83），P=0.002]。
在日本 AMI 患者中，较高的脂联素水平和较低的瘦素水平与不良事件的发生率较高相关，而瘦素与脂联素的比值可独立预测 AMI 后的预后。
