Abstract 1675: Adipokines and Coronary Heart Disease: Results From the Monica/Kora Augsburg Case-cohort Study, 1984–2002
Purpose - Adiponectin and leptin are both protein hormones secreted by adipose tissue. While leptin is a pleiotropic adipokine with structural and functional relation to proinflammatory cytokines, adiponection exerts strong anti-inflammatory effects on the cellular components of the vascular wall. Despite modulating a number of metabolic processes linked to atherosclerosis, including glucose regulation, insulin sensitivity, fatty acid catabolism and angiogenesis, their potential association with coronary heart disease (CHD) is still a matter of controversy.
Methods - We conducted a population-based case-cohort study using data from the MONICA/KORA Augsburg studies. Serum levels of adipokines were measured in 333 case subjects with incident CHD and 1,728 non-case subjects selected from a source population of 9,300 middle-aged men and women. The mean follow-up time was 10.8±4.6 years. In extension to previous studies we also sought to analyze the combined effect of leptin and adiponectin using the leptin/adiponectin ratio, since this ratio has previously been suggested to be a better indicator of atherosclerosis complications than each adipokine alone.
Results -Geometric means (SD) of leptin were 5.5 (1.1) ng/L in male and 22.4 (1.1) ng/L in female cases and 4.9 (1.0) in male and 16.7 (1.0) in female noncases, and for adiponectin in cases they were 9.5 (1.0) μg/mL for men and 12.5 (1.0) μg/mL for women and in noncases 9.4 (1.0) μg/mL for men and 13.4 (1.0) μg/mL for women. After adjustment for various confounders, including traditional cardiovascular risk factors, inflammatory markers and markers of endothelial dysfunction, the hazard ratios (HRs) and 95% confidence intervals (CIs) comparing tertile extremes were 0.79 (95% CI 0.53–1.17) for leptin (top vs bottom tertile) and 0.87 (95% CI 0.62–1.23) for adiponectin (bottom vs top tertile), respectively. Furthermore, the ratio of leptin/adiponectin also showed no association with CHD (HR 1.01 (95% CI 0.68 –1.51)).
Conclusions - In contrast to fairly strong associations previously reported, our findings, based on a large population-based cohort, indicate no clinically relevant association between leptin, adiponectin and their ratio with the risk of CHD after adjustment for potential confounders.