title: Leptin and incident cardiovascular disease: the Multi-ethnic Study of Atherosclerosis (MESA).
abstract: OBJECTIVE
  Higher serum leptin levels have been associated with a modestly higher incidence of cardiovascular disease in studies involving mostly Caucasian men. We aimed to assess the hypothesis that higher baseline levels of serum leptin are associated with higher risk of future cardiovascular disease in a diverse cohort.
  
  
  METHODS
  The Multi-Ethnic Study of Atherosclerosis (MESA) is a modern, community-based, ethnically-diverse, and sex-balanced prospective cohort study of US adults free from cardiovascular disease. Serum leptin was measured in an ancillary study in 2002-2005. This analysis included 1905 MESA participants with baseline leptin and incident cardiovascular event data. Leptin levels were modeled as a log-transformed continuous variable and multivariable-adjusted Cox regression was performed for the primary outcome of hard cardiovascular disease, including coronary heart disease and stroke.
  
  
  RESULTS
  The median follow-up was 7.6 years (25th-75th 7.1-8.3) with 7051 and 6738 person-years of follow-up in women and men. A hard cardiovascular disease event occurred in 47 women and 63 men. The age- and ethnicity-adjusted hazard ratio estimates for a 1 standard deviation increase in ln(leptin) were 1.16 in women (95% CI 0.78-1.73, p = 0.46) and 0.91 (95% CI 0.69-1.20, p = 0.51) in men. Pooling sexes, and adjusting for sex in addition to age and ethnicity, estimates were 0.98 (95% CI 0.78-1.23, p = 0.89). With additional adjustment for cardiovascular risk factors, the results remained nonsignificant: 0.87 (95% CI 0.68-1.11, p = 0.26).
  
  
  CONCLUSIONS
  In conclusion, in a modern, US prospective cohort study of multi-ethnic women and men of multi-ethnic backgrounds, leptin levels are not associated with incident cardiovascular events.
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA. Electronic address: smart100@jhmi.edu.
authors.forename: Seth S
authors.initials: SS
authors.lastname: Martin
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Blaha
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA; Scripps Translational Science Institute, La Jolla, CA, USA.
authors.forename: Evan D
authors.initials: ED
authors.lastname: Muse
authors.affiliation: Division of Cardiology, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Atif N
authors.initials: AN
authors.lastname: Qasim
authors.affiliation: Division of Cardiology, University of Pennsylvania Medical Center, Philadelphia, PA, USA.
authors.forename: Muredach P
authors.initials: MP
authors.lastname: Reilly
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA.
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA; Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, FL, USA; Miami Cardiovascular Institute (MCVI), Baptist Health South Florida, Miami, FL, USA; Department of Medicine, Herbert Wertheim College of Medicine, University Park, FL, USA; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA.
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
authors.affiliation: Division of Preventive Medicine, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Criqui
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, WA, USA.
authors.forename: Robyn L
authors.initials: RL
authors.lastname: McClelland
authors.affiliation: Division of Preventive Medicine, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Jan M
authors.initials: JM
authors.lastname: Hughes-Austin
authors.affiliation: Division of Preventive Medicine, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Allison
mesh_terms: D000368:Aged; D000886:Anthropometry; D050197:Atherosclerosis / Q000097:blood* / Q000208:ethnology*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000503:physiopathology; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012107:Research Design; D012307:Risk Factors; D012737:Sex Factors; D014481:United States
chemical_list: D020738:Leptin
keywords: Atherosclerosis; Cardiovascular disease; Heart failure; Leptin; Obesity