title: Diabetes and hypertension markedly increased the risk of ischemic stroke associated with high serum resistin concentration in a general Japanese population: the Hisayama Study.
abstract: BACKGROUND
  Resistin, secreted from adipocytes, causes insulin resistance in mice. The relationship between resistin and coronary artery disease is highly controversial, and the information regarding resistin and ischemic stroke is limited. In the present study, the association between serum resistin concentration and cardiovascular disease (CVD) was investigated in a general Japanese population.
  
  
  METHODS
  A total of 3,201 community-dwelling individuals aged 40 years or older (1,382 men and 1,819 women) were divided into quintiles of serum resistin, and the association between resistin and CVD was examined cross-sectionally. The combined effect of either diabetes or hypertension and high serum resistin was also assessed. Serum resistin was measured using ELISA.
  
  
  RESULTS
  Compared to those without CVD, age- and sex-adjusted mean serum resistin concentrations were greater in subjects with CVD (p = 0.002) or ischemic stroke (p < 0.001), especially in those with lacunar and atherothrombotic infarction, but not elevated in subjects with hemorrhagic stroke or coronary heart disease. When analyzed by quintile of serum resistin concentration, the age- and sex-adjusted odds ratio (OR) for having CVD and ischemic stroke increased with quintile of serum resistin (p for trends, 0.02 for CVD, < 0.001 for ischemic stroke), while such associations were not observed for hemorrhagic stroke or coronary heart disease. Compared to the first quintile, the age- and sex-adjusted OR of ischemic stroke was greater in the third (OR = 3.54; 95% confidence interval [CI], 1.17-10.67; p = 0.02), fourth (OR = 4.48; 95% CI, 1.53-13.09; p = 0.006), and fifth quintiles (OR = 4.70; 95% CI, 1.62-13.61; p = 0.004). These associations remained substantially unchanged even after adjustment for other confounding factors including high-sensitivity C-reactive protein. In the stratified analysis, the combination of high serum resistin and either diabetes or hypertension markedly increased the risk of ischemic stroke.
  
  
  CONCLUSIONS
  Elevated serum resistin concentration appears to be an independent risk factor for ischemic stroke, especially lacunar and atherothrombotic infarction in the general Japanese population. The combination of high resistin and the presence of either diabetes or hypertension increased the risk of ischemic stroke.
authors.affiliation: Department of Molecular and Genetic Medicine, Ehime University Graduate School of Medicine, Ehime, Japan. harosawa@m.ehime-u.ac.jp
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Osawa
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Doi
authors.forename: Hideichi
authors.initials: H
authors.lastname: Makino
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Koji
authors.initials: K
authors.lastname: Yonemoto
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Kawamura
authors.forename: Jun
authors.initials: J
authors.lastname: Hata
authors.forename: Yumihiro
authors.initials: Y
authors.lastname: Tanizaki
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Iida
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kiyohara
mesh_terms: D000328:Adult; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood / Q000208:ethnology / Q000209:etiology*; D002097:C-Reactive Protein / Q000032:analysis; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000097:blood / Q000208:ethnology / Q000209:etiology*; D003920:Diabetes Mellitus / Q000097:blood / Q000208:ethnology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications* / Q000208:ethnology; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D052243:Resistin / Q000097:blood*; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000208:ethnology / Q000209:etiology*; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C499624:RETN protein, human; D052243:Resistin; D002097:C-Reactive Protein