脂肪因子与右心室：MESA-RV研究
Adipokines and the Right Ventricle: The MESA-RV Study.
作者信息
Harhay Michael O, Kizer Jorge R, Criqui Michael H, Lima João A C, Tracy Russell, Bluemke David A, Kawut Steven M
机构信息
Penn Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America; Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
Department of Medicine, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America.
出版信息
PLoS One. 2015 Sep 8;10(9):e0136818. doi: 10.1371/journal.pone.0136818. eCollection 2015.
OBJECTIVE
Obesity is associated with changes in both right (RV) and left (LV) ventricular morphology, but the biological basis of this finding is not well established. We examined whether adipokine levels were associated with RV morphology and function in a population-based multiethnic sample free of clinical cardiovascular disease.
METHODS
We examined relationships of leptin, resistin, TNF-α, and adiponectin with RV morphology and function (from cardiac MRI) in participants (n = 1,267) free of clinical cardiovascular disease from the Multi-Ethnic Study of Atherosclerosis (MESA)-RV study. Multivariable regressions (linear, quantile [25th and 75th] and generalized additive models [GAM]) were used to examine the independent association of each adipokine with RV mass, RV end-diastolic volume (RVEDV), RV end-systolic volume (RVESV), RV stroke volume (RVSV) and RV ejection fraction (RVEF).
RESULTS
Higher leptin levels were associated with significantly lower levels of RV mass, RVEDV, RVESV and stroke volume, but not RVEF, after adjustment for age, gender, race, height and weight. These associations were somewhat attenuated but still significant after adjustment for traditional risk factors and covariates, and were completely attenuated when correcting for the respective LV measures. There were no significant interactions of age, gender, or race/ethnicity on the relationship between the four adipokines and RV structure or function.
CONCLUSIONS
Leptin levels are associated with favorable RV morphology in a multi-ethnic population free of cardiovascular disease, however these associations may be explained by a yet to be understood bi-ventricular process as this association was no longer present after adjustment for LV values. These findings complement the associations previously shown between adipokines and LV structure and function in both healthy and diseased patients. The mechanisms linking adipokines to healthy cardiovascular function require further investigation.
目的
肥胖与右心室（RV）和左心室（LV）形态的改变有关，但这一发现的生物学基础尚未完全明确。我们在一个无临床心血管疾病的多民族人群样本中，研究了脂肪因子水平与右心室形态和功能之间的关系。
方法
在动脉粥样硬化多民族研究（MESA）-RV研究中，对1267名无临床心血管疾病的参与者，检测瘦素、抵抗素、肿瘤坏死因子-α（TNF-α）和脂联素与右心室形态和功能（通过心脏磁共振成像）之间的关系。采用多变量回归分析（线性回归、分位数回归[第25和75百分位数]以及广义相加模型[GAM]），研究每种脂肪因子与右心室质量、右心室舒张末期容积（RVEDV）、右心室收缩末期容积（RVESV）、右心室搏出量（RVSV）和右心室射血分数（RVEF）的独立关联。
结果
在校正年龄、性别、种族、身高和体重后，较高的瘦素水平与显著较低的右心室质量、RVEDV、RVESV和搏出量相关，但与RVEF无关。在校正传统危险因素和协变量后，这些关联有所减弱但仍显著，而在校正相应的左心室指标后则完全减弱。年龄、性别或种族/民族在四种脂肪因子与右心室结构或功能的关系上无显著交互作用。
结论
在无心血管疾病的多民族人群中，瘦素水平与良好的右心室形态相关，但这些关联可能由尚未明确的双心室过程所解释，因为在校正左心室值后这种关联不再存在。这些发现补充了先前在健康和患病患者中所显示的脂肪因子与左心室结构和功能之间的关联。将脂肪因子与健康心血管功能联系起来的机制需要进一步研究。
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