Dessein Patrick H, Tsang Linda, Solomon Ahmed, Woodiwiss Angela J, Millen Aletta M E, Norton Gavin R
Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa.
Department of Rheumatology, Charlotte Maxeke Johannesburg Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa.
Mediators Inflamm. 2014;2014:358949. doi: 10.1155/2014/358949. Epub 2014 Jun 4.
In the present study, we examined the potential impact of adiponectin on carotid ultrasound determined atherosclerosis in 210 (119 black and 91 white) RA patients in mixed regression models. Total adiponectin concentrations were smaller in patients with compared to those without the metabolic syndrome (MetS) defined waist criterion (median (range) = 6.47 (1.23-34.54) versus 8.38 (0.82-85.30) ng/mL, P = 0.02, resp.); both total and high molecular weight (HMW) adiponectin concentrations were larger in patients with compared to those without joint deformities (7.97 (0.82-85.30) and 3.51 (0.01-35.40) versus 5.36 (1.29-19.49) and 2.34 (0.01-19.49) ng/mL, P = 0.003 and 0.02, resp.). Total and HMW adiponectin concentrations were associated with carotid artery plaque in patients with MetS waist (odds ratio (95% CI) = 0.87 (0.76-0.99) and 0.92 (0.85-0.99) per 1-standard deviation increment, P = 0.02 for both) and those without joint deformities (odds ratio (95% CI) = 0.94 (0.88-0.99) and 0.94 (0.89-0.99), P = 0.03 for both). Plaque prevalence was lower in patients without compared to those with joint deformities (23.4% versus 42.6, P = 0.004 in multivariable analysis). In RA patients with abdominal obesity or no clinically evident joint damage, adiponectin concentrations are reduced but nevertheless associated with decreased carotid atherosclerosis.
在本研究中，我们在混合回归模型中检测了脂联素对210例（119例黑人及91例白人）类风湿关节炎（RA）患者经颈动脉超声测定的动脉粥样硬化的潜在影响。与无代谢综合征（MetS）定义的腰围标准的患者相比，有该标准的患者总脂联素浓度更低（中位数（范围）=6.47（1.23 - 34.54）对8.38（0.82 - 85.30）ng/mL，P = 0.02）；与无关节畸形的患者相比，有关节畸形的患者总脂联素和高分子量（HMW）脂联素浓度均更高（7.97（0.82 - 85.30）和3.51（0.01 - 35.40）对5.36（1.29 - 19.49）和2.34（0.01 - 19.49）ng/mL，P分别为0.003和0.02）。总脂联素和HMW脂联素浓度与有MetS腰围的患者的颈动脉斑块相关（每增加1个标准差，比值比（95%可信区间）=0.87（0.76 - 0.99）和0.92（0.85 - 0.99），两者P = 0.02）以及与无关节畸形的患者的颈动脉斑块相关（比值比（95%可信区间）=0.94（0.88 - 0.99）和0.94（0.89 - 0.99），两者P = 0.03）。在多变量分析中，无关节畸形的患者的斑块患病率低于有关节畸形的患者（23.4%对42.6%，P = 0.004）。在有腹型肥胖或无临床明显关节损伤的RA患者中，脂联素浓度降低，但仍与颈动脉粥样硬化减轻相关。
