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J Am Heart Assoc. 2017 Jul 16;6(7). pii: e004974. doi: 10.1161/JAHA.116.004974.

Prospective Relation of Circulating Adipokines to Incident Metabolic Syndrome: The Framingham Heart Study.

Author information

1
Section of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX justin.zachariah@bcm.edu.
2
Cardiology Section, Boston University, Boston, MA.
3
Department of Biostatistics, Boston University School of Public Health, Boston, MA.
4
Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA.
5
Preventive Medicine Section, Boston University, Boston, MA.
6
Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA.
7
Boston University's and the National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA.

Abstract

BACKGROUND:

Adipokines are elaborated by adipose tissue and are associated with glycemic, lipid, and vascular traits. We hypothesized that in a cross-sectional analysis circulating adipokines are altered among subsets of obesity stratified by presence versus absence of metabolic syndrome (MetS) and prospectively predict the incidence of MetS.

METHODS AND RESULTS:

Participants in the community-based Framingham Third Generation Cohort who attended examination cycle 1 were included in the study (2002-2005; N=3777, mean age, 40 years; 59% women). Circulating adiponectin, leptin, leptin receptor, fetuin-A, fatty acid-binding protein 4, and retinol binding protein 4 were assayed and related to incident MetS in follow-up (mean 6 years). The adipokines were compared among individuals with excess body weight (body mass index ≥25 kg/m2) and prevalent MetS, excess body weight without MetS (metabolically healthy obese), and normal-weight with MetS (metabolically obese, normal-weight) with normal-weight participants without MetS as a referent. Metabolically healthy obese individuals (n=1467) had higher circulating levels of fetuin-A and fatty acid-binding protein 4 but lower levels of leptin, leptin receptor, and adiponectin (P<0.001 for all). The adipokine panel was associated with incident MetS (263 new-onset cases; P=0.002). Higher circulating concentrations of retinol-binding protein 4 and fetuin-A were associated with incidence of MetS (odds ratio per 1-SD increment log marker, 1.21; 95% CI, 1.03-1.41 [P=0.02] and 1.17; 95% CI, 1.01-1.34 [P=0.03], respectively).

CONCLUSIONS:

In our community-based sample of young to middle-aged adults, metabolically healthy obese individuals demonstrated an adverse adipokine profile. Higher circulating levels of retinol-binding protein 4 and fetuin-A marked future cardiometabolic risk.

KEYWORDS:

adipokine; epidemiology; metabolic syndrome; obesity; risk factor

PMID:
28713076
PMCID:
PMC5586264
DOI:
10.1161/JAHA.116.004974
[Indexed for MEDLINE]
Free PMC Article

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