CONTEXT:Hypoadiponectinemia has emerged as an independent risk factor for type 2 diabetes and cardiovascular disease. Although associations of adiponectin with central obesity and insulin resistance have been reported, very little data are available from studies using detailed measures of insulin sensitivity (S(I)) and/or body fat distribution in ethnic groups at high risk for metabolic disease. OBJECTIVE:The aim of the study was to identify the correlates of adiponectin in 1636 nondiabetic Hispanics and African-Americans. DESIGN:A cross-sectional analysis of participants in the Insulin Resistance Atherosclerosis Family Study was conducted. S(I) was determined from frequently sampled iv glucose tolerance tests with minimal model analysis. Subcutaneous and visceral adipose tissues (SAT, VAT, respectively) were determined with computed tomography. Triglyceride, high-density lipoprotein, C-reactive protein, and adiponectin were measured in fasting samples. Generalized estimating equation (GEE) models were used to identify factors associated with adiponectin concentration. SETTING:A multicenter study using a family-based design was conducted. PARTICIPANTS:A total of 1636 nondiabetic Hispanic and African-American subjects participated. MAIN OUTCOME MEASURES:Circulating adiponectin concentration was measured. RESULTS:Age, female gender, high-density lipoprotein, SAT, and S(I) were positive independent correlates of adiponectin, whereas glucose, CRP, and VAT were negative independent correlates (all P < 0.05). Ethnicity was not an independent correlate of adiponectin in this model (P = 0.27); however, an ethnicity by VAT interaction term was retained, indicating a stronger negative association of VAT with adiponectin in African-Americans compared with Hispanics. CONCLUSION:Directly measured S(I), VAT, and SAT were independently correlated with adiponectin in Hispanic and African-American subjects. The inverse association of VAT with adiponectin was stronger in African-Americans compared with Hispanics, a finding that suggests possible ethnic differences in the effects of visceral obesity.

译文

背景:低脂联素血症已成为2型糖尿病和心血管疾病的独立危险因素。尽管已经报道了脂联素与中枢性肥胖和胰岛素抵抗的相关性,但在代谢性疾病高危人群中,使用胰岛素敏感性(S(I))和/或体脂分布的详细测量方法的研究提供的数据很少。
目的:本研究的目的是鉴定脂联素在1636名非糖尿病性西班牙裔美国人和非裔美国人中的相关性。
设计:对胰岛素抵抗动脉粥样硬化家族研究的参与者进行了横断面分析。 S(I)是通过频繁采样的静脉糖耐量测试和最少的模型分析确定的。皮下和内脏脂肪组织(分别为SAT,VAT)通过计算机断层扫描确定。在禁食样品中测量甘油三酸酯,高密度脂蛋白,C反应蛋白和脂联素。使用广义估计方程(GEE)模型来确定与脂联素浓度相关的因素。
地点:使用基于家庭的设计进行了多中心研究。
参与者:共有1636名非糖尿病性西班牙裔和非裔美国人受试者参加。
主要观察指标:测量循环脂联素浓度。
结果:年龄,女性,高密度脂蛋白,SAT和S(I)与脂联素呈正相关,而葡萄糖,CRP和VAT与脂联素呈负相关(均P <0.05)。在该模型中,种族并不是脂联素的独立相关因素(P = 0.27);但是,保留了通过VAT交互作用的种族,这表明与西班牙裔美国人相比,非洲裔美国人中VAT与脂联素之间的负相关性更强。
结论:在西班牙裔和非裔美国人受试者中,直接测量的S(I),VAT和SAT与脂联素独立相关。与西班牙裔美国人相比,非裔美国人的增值税与脂联素的反向关联更强,这一发现表明内脏肥胖的影响可能存在种族差异。

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