title: Relationships between leptin and C-reactive protein with cardiovascular disease in the adult general population.
abstract: BACKGROUND
  Leptin could be a key regulator of C-reactive protein (CRP) levels, which serve as a marker of systemic inflammation. Both leptin and CRP are predictors of cardiovascular disease (CVD). However, the interactions between leptin and CRP, and their association with CVD, remain unclear. We therefore studied them in a large, multiethnic population.
  
  
  METHODS
  We analyzed leptin and CRP levels, anthropometric variables and cardiovascular risk factor data from 6,251 participants from the Third National Health and Nutrition Examination Survey (NHANES III). Logistic regression was used to estimate the association between leptin, CRP and CVD (defined as history of myocardial infarction or stroke). Receiver operating characteristic curves were created to study the additional value of leptin and CRP for the association with CVD.
  
  
  RESULTS
  The mean age was 44.4 +/- 0.21 years (52.5% women). After adjustment for age, race, dyslipidemia, hypertension, diabetes, smoking, obesity and CRP, high levels of leptin were significantly associated with CVD in men (odds ratio 2.47, 95% CI 1.19-5.19) and in women (odds ratio 3.30, 95% CI 1.47-7.99). After adjustment for leptin, CRP was not associated with CVD. There was a significant correlation between levels of leptin and CRP (Spearman correlation rho = 0.22 in men and rho = 0.32 in women, both P < 0.0001). The area under the curve, representing the association between cardiovascular risk factors and CVD, increased after the addition of high levels of both leptin and CRP together.
  
  
  CONCLUSIONS
  High leptin levels are independently associated with CVD even after adjustment for CRP; elevated CRP levels are not associated with CVD after adjustment for leptin. However, increased concentrations of both leptin and CRP confer the highest risk for CVD.
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Mayo Foundation, 200 First Street SW, Rochester, MN 55905, USA.
authors.forename: Abel
authors.initials: A
authors.lastname: Romero-Corral
authors.forename: Justo
authors.initials: J
authors.lastname: Sierra-Johnson
authors.forename: Francisco
authors.initials: F
authors.lastname: Lopez-Jimenez
authors.forename: Randal J
authors.initials: RJ
authors.lastname: Thomas
authors.forename: Prachi
authors.initials: P
authors.lastname: Singh
authors.forename: Michal
authors.initials: M
authors.lastname: Hoffmann
authors.forename: Aynur
authors.initials: A
authors.lastname: Okcay
authors.forename: Josef
authors.initials: J
authors.lastname: Korinek
authors.forename: Robert
authors.initials: R
authors.lastname: Wolk
authors.forename: Virend K
authors.initials: VK
authors.lastname: Somers
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood*; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D015415:Biomarkers; D020738:Leptin; D002097:C-Reactive Protein