Department of Community Health and Preventive Medicine, Morehouse School of Medicine Atlanta, GA, USA.
Department of Medicine, University of Mississippi Medical Center Jackson, MS, USA.
Front Public Health. 2013 May 24;1:16. doi: 10.3389/fpubh.2013.00016. eCollection 2013.
Because the predictive significance of previously reported racial differences in leptin and adiponectin levels remains unclear, we assessed the prospective association of these adipokines with the risk of cardiovascular disease (CVD) events in African Americans, a population with a high prevalence of cardiometabolic risk factors.
Serum specimens from 4,571 Jackson Heart Study participants without prevalent CVD at baseline examination (2000-2004) were analyzed for adiponectin and leptin levels. Cox proportional hazard regression models were used to estimate the associations of the two adipokines with incident coronary heart disease (CHD) and incident ischemic stroke.
During 6.2 years average of follow-up, 98 incident CHD and 87 incident ischemic stroke events were documented. Among study participants (64% women; mean age 54 ± 13 years), the mean (standard deviation, SD) was 6.04 (4.32) μg/mL in women and 4.03 (3.14) μg/mL in men for adiponectin and 37.35 (23.90) ng/mL in women and 11.03 (10.05) ng/mL in men for leptin. After multivariable adjustment that included age, body mass index, high-density lipoprotein cholesterol, triglycerides, C-reactive protein, insulin resistance by homeostasis model assessment for insulin resistance, systolic blood pressure, hypertension medication, smoking, and physical activity, adiponectin was directly associated in women with incident stroke, HR = 1.41 (1.04-1.91) per one SD increase (p = 0.03), but not in men (p = 0.42). It was not associated with incident CHD in women or men. Leptin was not associated with incident CHD or incident stroke.
In the largest community-based African American cohort, adiponectin was associated among women with a higher risk of incident stroke. Whether adiponectin harbors harmful properties, or it is produced in response to vascular inflammation to counter the atherosclerotic process, or the putative "adiponectin resistance" phenomenon acts, should be further assessed.
由于先前报道的瘦素和脂联素水平的种族差异的预测意义仍不清楚，我们评估了这些脂肪因子与非裔美国人心血管疾病（CVD）事件风险的前瞻性关联，该人群存在高心血管代谢危险因素。
在基线检查（2000-2004 年）时，对 4571 名无现有 CVD 的 Jackson 心脏研究参与者的血清标本进行脂联素和瘦素水平分析。Cox 比例风险回归模型用于估计这两种脂肪因子与冠心病（CHD）和缺血性卒中事件的发生。
在平均 6.2 年的随访期间，记录了 98 例冠心病和 87 例缺血性卒中事件。在研究参与者中（64%为女性；平均年龄 54±13 岁），女性的平均（标准差，SD）脂联素为 6.04（4.32）μg/mL，男性为 4.03（3.14）μg/mL；女性瘦素为 37.35（23.90）ng/mL，男性为 11.03（10.05）ng/mL。经过包括年龄、体重指数、高密度脂蛋白胆固醇、甘油三酯、C 反应蛋白、稳态模型评估的胰岛素抵抗、收缩压、高血压药物、吸烟和体力活动在内的多变量调整后，女性中脂联素与卒中事件的发生直接相关，HR=1.41（1.04-1.91），每增加一个 SD（p=0.03），而男性则没有（p=0.42）。它与女性或男性的冠心病事件无关。瘦素与冠心病或缺血性卒中事件无关。
在最大的非裔美国人社区队列中，脂联素与女性卒中风险增加有关。脂联素是否具有有害特性，或者它是为了对抗动脉粥样硬化过程而产生的血管炎症反应，或者所谓的“脂联素抵抗”现象起作用，应该进一步评估。
