脂肪因子与代谢健康随时间的转变：社区动脉粥样硬化风险（ARIC）研究

Adipokines and Transitions in Metabolic Health Over Time: The Atherosclerosis Risk In Communities (ARIC) Study.

作者信息

Ozkan Bige, Zhang Sui, Echouffo-Tcheugui Justin B, Florido Roberta, Nambi Vijay, Michos Erin D, Abushamat Layla A, Matsushita Kunihiro, Gerstenblith Gary, Blumenthal Roger S, Hoogeveen Ron, Ballantyne Christie M, Coresh Josef, Selvin Elizabeth, Ndumele Chiadi E

机构信息

Division of Cardiology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.

Department of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

出版信息

J Clin Endocrinol Metab. 2025 Jan 7. doi: 10.1210/clinem/dgae916.

DOI:10.1210/clinem/dgae916

PMID:39761818

Abstract

CONTEXT

Transitions in metabolic health status over time are strongly linked to risk for cardiovascular events, particularly among individuals with obesity. Adipokines are proteins with metabolic effects, but their role in transitions in metabolic health status over time is unknown.

OBJECTIVE

To evaluate the associations of adiponectin and leptin with metabolic risk transitions over time.

METHODS

Among 8,423 individuals who attended ARIC Visits 2 (1990-92) and 4 (1996-98), we evaluated prospective associations of Visit 2 levels of the adipokines adiponectin and leptin (per 1-SD higher) with 6-year transitions in metabolic health. Metabolic health was categorized as metabolically "healthy" (no metabolic syndrome [MetS] or diabetes), unhealthy (MetS present) without diabetes, or unhealthy with diabetes. Analyses were performed overall and stratified by obesity (body mass index [BMI] ≥30 kg/m2).

RESULTS

At Visit 2, the mean age was 58, with 56% female and 21% Black adults. Adults with 1-SD higher adiponectin were less likely to progress from metabolically healthy to unhealthy status over 6 years (OR 0.53, 95%CI: 0.48-0.57), while those with higher leptin were more likely to progress (OR 2.22, 95%CI: 2.01-2.47). Conversely, those with 1-SD higher adiponectin were more likely to regress from metabolically unhealthy to healthy status (OR 1.58, 95% CI: 1.42-1.76), while those with higher leptin were less likely to regress (OR 0.68, 95% CI: 0.60-0.78). Similar patterns were seen across obesity strata. After adjustment for BMI, associations of adiponectin with metabolic transitions were similar, whereas associations for leptin were significantly attenuated.

CONCLUSION

Leptin and adiponectin are differentially linked to the likelihood of worsening and improving metabolic health over time. Adipokines should be explored as targets to improve metabolic health and decrease the risk of future cardiovascular events.

摘要

背景

随着时间推移，代谢健康状况的转变与心血管事件风险密切相关，尤其是在肥胖个体中。脂肪因子是具有代谢作用的蛋白质，但其在代谢健康状况随时间转变中的作用尚不清楚。

目的

评估脂联素和瘦素与随时间变化的代谢风险转变之间的关联。

方法

在参加动脉粥样硬化多中心研究（ARIC）第2次访视（1990 - 1992年）和第4次访视（1996 - 1998年）的8423名个体中，我们评估了第2次访视时脂联素和瘦素水平（每升高1个标准差）与6年代谢健康转变的前瞻性关联。代谢健康分为代谢“健康”（无代谢综合征[MetS]或糖尿病）、不健康（有MetS）但无糖尿病、或不健康且有糖尿病。分析在总体人群中进行，并按肥胖程度（体重指数[BMI]≥30 kg/m²）分层。

结果

在第2次访视时，平均年龄为58岁，女性占56%，黑人成年人占21%。脂联素水平每升高1个标准差的成年人在6年内从代谢健康转变为不健康状态的可能性较小（比值比[OR] 0.53，95%置信区间[CI]：0.48 - 0.57），而瘦素水平较高的成年人转变的可能性更大（OR 2.22，95%CI：2.01 - 2.47）。相反，脂联素水平每升高1个标准差的成年人从不健康转变为健康状态的可能性更大（OR 1.58，95%CI：1.42 - 1.76），而瘦素水平较高的成年人转变的可能性较小（OR 0.68，95%CI：0.60 - 0.78）。在各肥胖分层中观察到类似模式。在调整BMI后，脂联素与代谢转变的关联相似，而瘦素的关联显著减弱。