Norvik Jon V, Schirmer Henrik, Ytrehus Kirsti, Jenssen Trond G, Zykova Svetlana N, Eggen Anne E, Eriksen Bjørn O, Solbu Marit D
Metabolic and Renal Research Group, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.
Cardiovascular Research Group IMB, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.
BMC Cardiovasc Disord. 2017 Mar 14;17(1):79. doi: 10.1186/s12872-017-0509-2.
Heart failure with preserved ejection fraction is closely associated with diastolic dysfunction and related to obesity and female sex. We investigated whether adiponectin, an adipocyte-secreted protein hormone with cardioprotective effects, was associated with indices of diastolic dysfunction, and whether the association was sex dependent.
We conducted a cross-sectional study on 1165 women and 896 men without diabetes. We stratified the multivariable adjusted logistic regression analyses and the fractional polynomial regression analyses according to sex, with echocardiographic markers of diastolic dysfunction as dependent variables, and adiponectin as the independent variable of interest.
Decreased adiponectin was associated with higher odds of average tissue Doppler e' < 9 in women (odds ratio [OR] 1.17 per 1 μg/mL adiponectin decrease, 95% confidence interval [CI] 1.04-1.30), but not in men (p for interaction with sex 0.04). Women, but not men, had higher odds of E/e' ratio ≥ 8 with lower adiponectin (OR 1.12 per 1 μg/mL adiponectin decrease, 95% CI 1.02-1.24, p for interaction with sex 0.04). Adiponectin in the lower sex-specific tertile was associated with increased odds of concentric left ventricular hypertrophy in women (OR 2.44, 95% CI 1.03-5.77), but with decreased odds in men (OR 0.32, 95% CI 0.11-0.88, p for interaction with sex 0.002), and decreased odds of eccentric hypertrophy in men only (OR 0.53, 95% CI 0.33-0.88, p for interaction with sex 0.02). Adiponectin in the lower sex-specific tertile was associated with moderately enlarged left atria in women only (OR 1.43, 95% CI 1.01-2.03, p for interaction with sex 0.04). Finally, adiponectin had a non-linear relationship with left ventricular mass in women only, with exponentially increasing left ventricular mass with lower adiponectin levels (p for interaction with sex 0.01).
Low adiponectin was associated with higher odds of indices of diastolic dysfunction in women, but lower odds of indices of diastolic dysfunction in men. Lower adiponectin was associated with increased left ventricular mass in women only.
射血分数保留的心力衰竭与舒张功能障碍密切相关，且与肥胖及女性性别有关。我们研究了脂联素（一种具有心脏保护作用的脂肪细胞分泌蛋白激素）是否与舒张功能障碍指标相关，以及这种关联是否存在性别差异。
我们对1165名女性和896名无糖尿病男性进行了一项横断面研究。我们根据性别对多变量调整逻辑回归分析和分数多项式回归分析进行分层，以舒张功能障碍的超声心动图指标作为因变量，脂联素作为感兴趣的自变量。
脂联素降低与女性平均组织多普勒e'＜9的较高几率相关（每降低1μg/mL脂联素，比值比[OR]为1.17，95%置信区间[CI]为1.04 - 1.30），但在男性中并非如此（与性别交互作用的p值为0.04）。脂联素水平较低时，女性E/e'比值≥8的几率较高（每降低1μg/mL脂联素，OR为1.12，95%CI为1.02 - 1.24，与性别交互作用的p值为0.04），而男性并非如此。女性中处于较低性别特异性三分位数的脂联素与同心性左心室肥厚几率增加相关（OR为2.44，95%CI为1.03 - 5.77），但在男性中与几率降低相关（OR为0.32，95%CI为0.11 - 0.88，与性别交互作用的p值为0.002），且仅在男性中与离心性肥厚几率降低相关（OR为0.53，95%CI为0.33 - 0.88，与性别交互作用的p值为0.02）。女性中处于较低性别特异性三分位数的脂联素仅与左心房中度扩大相关（OR为1.43，95%CI为1.01 - 2.03，与性别交互作用的p值为0.04）。最后，脂联素仅在女性中与左心室质量呈非线性关系，脂联素水平较低时左心室质量呈指数增加（与性别交互作用的p值为0.01）。
低脂联素与女性舒张功能障碍指标的较高几率相关，但与男性舒张功能障碍指标的较低几率相关。较低的脂联素仅与女性左心室质量增加相关。
