title: Associations of adiponectin and leptin with incident coronary heart disease and ischemic stroke in african americans: the jackson heart study.
abstract: BACKGROUND
  Because the predictive significance of previously reported racial differences in leptin and adiponectin levels remains unclear, we assessed the prospective association of these adipokines with the risk of cardiovascular disease (CVD) events in African Americans, a population with a high prevalence of cardiometabolic risk factors.
  
  
  METHODS
  Serum specimens from 4,571 Jackson Heart Study participants without prevalent CVD at baseline examination (2000-2004) were analyzed for adiponectin and leptin levels. Cox proportional hazard regression models were used to estimate the associations of the two adipokines with incident coronary heart disease (CHD) and incident ischemic stroke.
  
  
  RESULTS
  During 6.2 years average of follow-up, 98 incident CHD and 87 incident ischemic stroke events were documented. Among study participants (64% women; mean age 54 ± 13 years), the mean (standard deviation, SD) was 6.04 (4.32) μg/mL in women and 4.03 (3.14) μg/mL in men for adiponectin and 37.35 (23.90) ng/mL in women and 11.03 (10.05) ng/mL in men for leptin. After multivariable adjustment that included age, body mass index, high-density lipoprotein cholesterol, triglycerides, C-reactive protein, insulin resistance by homeostasis model assessment for insulin resistance, systolic blood pressure, hypertension medication, smoking, and physical activity, adiponectin was directly associated in women with incident stroke, HR = 1.41 (1.04-1.91) per one SD increase (p = 0.03), but not in men (p = 0.42). It was not associated with incident CHD in women or men. Leptin was not associated with incident CHD or incident stroke.
  
  
  CONCLUSIONS
  In the largest community-based African American cohort, adiponectin was associated among women with a higher risk of incident stroke. Whether adiponectin harbors harmful properties, or it is produced in response to vascular inflammation to counter the atherosclerotic process, or the putative "adiponectin resistance" phenomenon acts, should be further assessed.
authors.affiliation: Department of Community Health and Preventive Medicine, Morehouse School of Medicine Atlanta, GA, USA.
authors.forename: Aurelian
authors.initials: A
authors.lastname: Bidulescu
authors.affiliation: Department of Medicine, University of Mississippi Medical Center Jackson, MS, USA.
authors.forename: Jiankang
authors.initials: J
authors.lastname: Liu
authors.affiliation: Rural Health Research Center, University of South Carolina Columbia, SC, USA.
authors.forename: Zhimin
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Medicine, University of Mississippi Medical Center Jackson, MS, USA ; School of Health Sciences, Jackson State University Jackson, MS, USA.
authors.forename: Demarc A
authors.initials: DA
authors.lastname: Hickson
authors.affiliation: Department of Medicine, University of Mississippi Medical Center Jackson, MS, USA.
authors.forename: Solomon K
authors.initials: SK
authors.lastname: Musani
authors.affiliation: Department of Medicine, University of Mississippi Medical Center Jackson, MS, USA.
authors.forename: Tandaw E
authors.initials: TE
authors.lastname: Samdarshi
authors.affiliation: Department of Medicine, University of Mississippi Medical Center Jackson, MS, USA.
authors.forename: Ervin R
authors.initials: ER
authors.lastname: Fox
authors.affiliation: Department of Medicine, University of Mississippi Medical Center Jackson, MS, USA ; School of Health Sciences, Jackson State University Jackson, MS, USA.
authors.forename: Herman A
authors.initials: HA
authors.lastname: Taylor
authors.affiliation: National Heart Lung and Blood Institute, National Institutes of Health Bethesda, MD, USA.
authors.forename: Gary H
authors.initials: GH
authors.lastname: Gibbons
keywords: African Americans; adiponectin; cardiovascular events; cohort study; leptin; minorities; stroke