Sharma Shishir, Colangelo Laura A, Allison Matthew A, Lima Joao A C, Ambale-Venkatesh Bharath, Kishi Satoru, Liu Kiang, Greenland Philip
Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
University of California, San Diego, CA, United States.
Int J Cardiol. 2015 Aug 15;193:64-8. doi: 10.1016/j.ijcard.2015.05.068. Epub 2015 May 14.
BACKGROUND/OBJECTIVES: Earlier studies differ on whether serum leptin is associated with adverse or beneficial cardiac structure. We determined the association between serum leptin with subsequent cardiac structure and function.
MESA is a multicenter longitudinal study of Black, White, Hispanic and Asian-American men and women. Cardiac MRI (CMR) was completed 6 to 8 years after leptin was measured. Left ventricular (LV) mass and volumes were indexed to body surface area. Multivariable linear regression models were constructed to assess the associations between leptin and risk factor adjusted (age, race, gender, systolic blood pressure, anti-hypertensive usage, LDL, HDL, hyperlipidemia medication usage, diabetes, diabetic medication usage, chronic kidney disease, alcohol and tobacco use, adiponectin and BMI) CMR variables.
Relative to participants in the lowest quintile of leptin concentration, participants in the highest quintile had a lower risk factor adjusted LV mass (-14 g), LV mass index (-9 g/m(2)), LV end diastolic volume index (LVEDVi) (-7 ml/m(2)), LV end systolic volume index (LVESVi) (-3 ml/m(2)) and stroke volume (-5 ml) (all p≤0.05). On regression analysis, a doubling of leptin concentration was associated with lower LV mass (-2.5 g ± 0.7 g), LV mass index (-1.7 ± 0.3g/m(2)), LVEDVi (-1.5 ± 0.4 ml/m(2)), LVESVi (-0.7 ± 0.2 ml/m(2)) and stroke volume (-1.0 ± 0.5 ml) (all p ≤ 0.05).
Higher leptin was associated with more favorable subsequent cardiac structure. Further study is needed to assess the prognostic and therapeutic implications of these observations.
背景/目的：早期研究对于血清瘦素与不良或有益的心脏结构之间是否存在关联存在分歧。我们确定了血清瘦素与后续心脏结构和功能之间的关联。
多族裔动脉粥样硬化研究（MESA）是一项针对黑人、白人、西班牙裔和亚裔美国男性和女性的多中心纵向研究。在测量瘦素6至8年后完成心脏磁共振成像（CMR）。左心室（LV）质量和容积以体表面积进行指数化。构建多变量线性回归模型，以评估瘦素与经风险因素调整（年龄、种族、性别、收缩压、抗高血压药物使用、低密度脂蛋白、高密度脂蛋白、高脂血症药物使用、糖尿病、糖尿病药物使用、慢性肾脏病、酒精和烟草使用、脂联素和体重指数）的CMR变量之间的关联。
相对于瘦素浓度处于最低五分位数的参与者，处于最高五分位数的参与者经风险因素调整后的左心室质量较低（-14克）、左心室质量指数较低（-9克/平方米）、左心室舒张末期容积指数（LVEDVi）较低（-7毫升/平方米）、左心室收缩末期容积指数（LVESVi）较低（-3毫升/平方米）和每搏输出量较低（-5毫升）（所有p≤0.05）。回归分析显示，瘦素浓度加倍与较低的左心室质量（-2.5克±0.7克）、左心室质量指数（-1.7±0.3克/平方米）、LVEDVi（-1.5±0.4毫升/平方米）、LVESVi（-0.7±0.2毫升/平方米）和每搏输出量（-1.0±0.5毫升）相关（所有p≤0.05）。
较高的瘦素与更有利的后续心脏结构相关。需要进一步研究以评估这些观察结果的预后和治疗意义。
