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非裔美国人血浆脂联素与肺动脉高压、死亡率及心力衰竭的关联:杰克逊心脏研究

Association of plasma adiponectin with pulmonary hypertension, mortality and heart failure in African Americans: Jackson Heart Study.

作者信息

Lakshmanan Suvasini, Jankowich Matthew, Wu Wen-Chih, Abbasi Siddique, Morrison Alan R, Choudhary Gaurav

机构信息

Division of Cardiology, Providence VA Medical Center, Alpert Medical School of Brown University, Providence, RI, USA.

Division of Pulmonary, Critical Care and Sleep Medicine, Providence VA Medical Center and Alpert Medical School of Brown University, Providence, RI, USA.

出版信息

Pulm Circ. 2020 Nov 11;10(4):2045894020961242. doi: 10.1177/2045894020961242. eCollection 2020 Oct-Dec.

Abstract

BACKGROUND

Adiponectin is a polypeptide hormone related to obesity, and a known modulator of pulmonary vascular remodeling. Association between plasma adiponectin levels and pulmonary hypertension (PH) has not been studied in African Americans (AAs) who are disproportionately affected by obesity. The relationship between adiponectin and heart failure (HF) and mortality, outcomes associated with PH, is unclear.

METHODS

We performed cross-sectional and longitudinal analysis to examine if there is an association between plasma adiponectin and PH and associated clinical outcomes, in participants of Jackson Heart Study (JHS). JHS is a prospective observational cohort study of heart disease in AAs from Jackson, Mississippi.

RESULTS

Of the 3161 participants included in the study, mean age (SD) was 56.38 (12.61) years, 1028 were men (32.5%), and mean (SD) BMI was 31.42 (7.05) kg/m. Median (IQR) adiponectin was 4516.82 (2799.32-7065.85) ng/mL. After adjusting for potential confounders including BMI, higher adiponectin levels were associated with increased odds of PH (adjusted odds ratio per log increment in adiponectin, (1.81; 95% CI, 1.41-2.32). High adiponectin levels were also associated with associated HF admissions (adjusted hazard ratio [HR] per log increment in adiponectin, 1.63, 95% CI, 1.24-2.14) and mortality (adjusted HR per log increment in adiponectin, 1.20; 95% CI 1.02-1.41).

CONCLUSIONS

Elevated plasma adiponectin levels are associated with PH, HF admissions and mortality risk in AAs. High adiponectin levels may help identify an at-risk population that could be evaluated for targeted prevention and management strategies in future studies.

摘要

背景

脂联素是一种与肥胖相关的多肽激素,也是已知的肺血管重塑调节因子。血浆脂联素水平与肺动脉高压(PH)之间的关联尚未在受肥胖影响尤为严重的非裔美国人(AA)中进行研究。脂联素与心力衰竭(HF)以及与PH相关的死亡率和预后之间的关系尚不清楚。

方法

我们进行了横断面和纵向分析,以检验杰克逊心脏研究(JHS)参与者的血浆脂联素与PH及相关临床结局之间是否存在关联。JHS是一项对密西西比州杰克逊市非裔美国人心脏病进行的前瞻性观察队列研究。

结果

在纳入研究的3161名参与者中,平均年龄(标准差)为56.38(12.61)岁,1028名是男性(32.5%),平均(标准差)体重指数为31.42(7.05)kg/m²。脂联素的中位数(四分位间距)为4516.82(2799.32 - 7065.85)ng/mL。在对包括体重指数在内的潜在混杂因素进行调整后,较高的脂联素水平与PH几率增加相关(脂联素每对数增量的调整优势比,(1.81; 95%可信区间,1.41 - 2.32))。高脂联素水平还与HF入院(脂联素每对数增量的调整风险比[HR],1.63,95%可信区间,1.24 - 2.14)和死亡率(脂联素每对数增量的调整HR,1.20;95%可信区间1.02 - 1.41)相关。

结论

血浆脂联素水平升高与非裔美国人的PH、HF入院和死亡风险相关。高脂联素水平可能有助于识别一个高危人群,以便在未来研究中对其进行针对性预防和管理策略的评估。

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