Adiposity, Adipokines, and Risk of Incident Stroke in Older Men

Abstract

Background and Purpose— The association between adiposity and adipocytes and risk of stroke in older adults is uncertain. We have examined the association between adiposity measures and adipocytes (adiponectin and leptin) with incident stroke events in older men. Methods— Prospective study of 3411 men aged 60 to 79 years with no previous diagnosis of myocardial infarction, heart failure, or stroke followed-up for an average of 9 years, during which there were 192 incident major stroke events. Results— In age-adjusted analyses, body mass index and waist circumference were not significantly associated with risk of stroke in older men, although obese men (body mass index >30 kg/m 2 ) showed the lowest risk of stroke. Despite the strong positive correlation between leptin and body mass index and waist circumference, risk of stroke was significantly increased in those in the top quartile of the leptin distribution. The increased risk remained after adjustment for potential confounders, including systolic blood pressure (adjusted hazard ratios top quartile versus bottom quartile: 2.03; confidence interval, 1.27–3.27]). Further adjustment for markers of inflammation (c-reactive protein), endothelial dysfunction (von Willebrand factor), fibrinolytic activity (d-dimer), and γ-glutamyl transferase attenuated the increased risk, but risk remained significantly increased (adjusted hazard ratios, 1.73; confidence interval, 1.06–2.83]). By contrast, no association was seen between adiponectin and risk of stroke. Conclusions— Conventional adiposity measures were not associated with increased stroke risk in older men. However, leptin (a good marker of percent fat mass), but not adiponectin, predicted stroke, suggesting a link between fat mass and stroke risk.

Association of leptin levels with pathogenetic risk of coronary heart disease and stroke: a meta-analysis

“…Furthermore, their further research (26) indicated that leptin was an independent predictor of stroke in men, even after adjustment for traditional stroke risk factors. This result is consistent with a recent report (18) that leptin was associated with incident stroke after adjusting for BMI and established risk factors for stroke. This report also contains a suggestion that direct atherogenic effect of leptin on the carotid artery wall may be the pathway for develop ment of stroke.…”

“…A large prospective study was conducted to examine the association of leptin levels with the risk of CHD indicating that leptin was a novel, independent risk factor for CHD (13), similarly, another investigation concluded that high leptin level was significantly associated with myocardial infarction as well as stroke in men and women, independently of several cardiovascular risk factors and obese status (14). Additionally, significant association of leptin levels with risk of CHD and stroke were also demonstrated by other studies focused on these relationships (15)(16)(17)(18). On the other hand, in contrast to those fairly strong associations previously reported, a recent prospective study and systematic review have found that a moderate association was existed between leptin levels and CHD risk, but no statistically significant association was observed after adjustment for body mass index (BMI) (9) which is consistent with another report from populationbased case-cohort study (12).…”

Czy adiponektyna stanowi czynnik ryzyka występowania napadów przemijającego niedokrwienia mógu/przemijającego niedokrwienia mózgu?

“…In our study no difference was found in terms of ADP values between patients and control group subjects. On the other hand, sex may affect the ADP levels [23]. But we did not find a correlation between ADP and sex.…”

“…A systematic review and meta-analysis of 16 prospective studies also reported that the ADP level was not related to the risk of ischaemic stroke [23]. However, Hao et al concluded, in a meta-analysis including 17 prospective studies, that higher ADP was associated with an increased risk of ischaemic stroke [24].…”

The Abundance of Epicardial Adipose Tissue Surrounding Left Atrium Is Associated With the Occurrence of Stroke in Patients With Atrial Fibrillation

“…Several laboratory reports have provided plausible reasons for this relationship. 36–38 First, adipocytes can infiltrate into the atrial myocardium and result in the hypokinesia of the LA and LAA. Second, the adipocytokines secreted from EAT possess anticontractile properties and induce myocardial fibrosis.…”