Department of Family Medicine & Public Health, University of California, San Diego, CA, USA.
Department of Family Medicine & Public Health, University of California, San Diego, CA, USA.
Atherosclerosis. 2017 Oct;265:1-6. doi: 10.1016/j.atherosclerosis.2017.07.022. Epub 2017 Jul 22.
Adipokines are known to predict cardiovascular events, yet their association with coronary artery calcium (CAC), a surrogate marker of coronary atherosclerosis and risk factor for cardiovascular disease (CVD), is unclear. We aimed at assessing the association between adipokines and the severity and progression of CAC in healthy older adults, and at exploring potential modification by gender.
409 men and women from the Rancho Bernardo Study with no known CVD underwent a chest computed tomography scan to determine baseline CAC severity; 329 returned 4.5 years later for a repeat scan to evaluate CAC progression. Adipokines (IL-6, adiponectin, leptin, and TNF-α) were measured from baseline blood samples. Ordinal linear and logistic regression models were used to determine the association of each adipokine with baseline severity and future progression of CAC.
Adjusting for age and sex, IL-6 and leptin were associated with greater odds of increasing CAC severity (OR = 1.63, 95% CI 1.22-2.19; OR = 1.19, 95% CI 0.99-1.43, respectively, per SD). The association with IL-6 remained significant in models further adjusted for lifestyle, body size, CVD risk factors, and body fat distribution. Adiponectin was associated with CAC progression (OR = 0.68, 95% CI 0.51-0.92 in fully adjusted models). This was modified by sex, with protective effects seen for men (OR = 0.57, 95% CI 0.38-0.85), but not for women (OR = 0.93, 95% CI 0.67-1.32; p-for-interaction = 0.04).
IL-6 and leptin predicted greater CAC severity while adiponectin predicted lower odds of CAC progression. More research is needed to explore biological mechanisms, including differences by sex.
脂肪因子已知可预测心血管事件，但它们与冠状动脉钙（CAC）的关系，即冠状动脉粥样硬化的替代标志物和心血管疾病（CVD）的危险因素，尚不清楚。我们旨在评估脂肪因子与健康老年人 CAC 的严重程度和进展之间的关系，并探讨性别可能产生的影响。
Rancho Bernardo 研究中的 409 名男女参与者在研究之初接受了胸部 CT 扫描，以确定 CAC 严重程度的基线值；其中 329 人在 4.5 年后返回进行重复扫描，以评估 CAC 的进展情况。从基线血样中测量脂肪因子（IL-6、脂联素、瘦素和 TNF-α）。使用有序线性和逻辑回归模型来确定每种脂肪因子与 CAC 基线严重程度和未来进展的关系。
在校正年龄和性别后，IL-6 和瘦素与 CAC 严重程度增加的几率更高相关（OR=1.63，95%CI 1.22-2.19；OR=1.19，95%CI 0.99-1.43，每标准差）。在进一步调整生活方式、体型、CVD 危险因素和体脂分布的模型中，IL-6 的相关性仍然显著。脂联素与 CAC 进展相关（在完全调整模型中，OR=0.68，95%CI 0.51-0.92）。这种相关性受性别影响，对男性具有保护作用（OR=0.57，95%CI 0.38-0.85），但对女性没有影响（OR=0.93，95%CI 0.67-1.32；p 交互=0.04）。
IL-6 和瘦素预测 CAC 严重程度更高，而脂联素预测 CAC 进展的几率更低。需要进一步研究以探索生物学机制，包括性别差异。
