AIMS/HYPOTHESIS Higher concentrations of the adipokine omentin are associated with lower levels of cardiometabolic risk factors in experimental and cross-sectional studies, but with higher risk of type 2 diabetes and cardiovascular diseases in population-based cohort studies. However, it is unknown whether high omentin concentrations are associated with increased risk of cardiovascular events in people with established diabetes. Therefore, the present study investigated the association between serum omentin concentrations and the risk of cardiovascular events in individuals with diabetes. METHODS This prospective study was based on participants of the German ESTHER cohort with diabetes and without previous cardiovascular event. The ESTHER cohort consists of individuals aged 50-75 years at baseline who were recruited by their general practitioners. After exclusion of individuals with serum C-reactive protein ≥10 mg/l (≥95.24 nmol/l), the final analysis population consisted of 933 individuals. At baseline, serum omentin concentrations were measured by ELISA. Cox regression models were fitted to estimate HRs and their corresponding 95% CIs for associations of omentin tertiles with a composite endpoint of cardiovascular events and separately with incident myocardial infarction, stroke and cardiovascular death. RESULTS During 14 years of follow-up, 228 individuals experienced a primary cardiovascular event (myocardial infarction, stroke or cardiovascular death). After comprehensive adjustment for age, sex, BMI, metabolic and lifestyle factors and medication use, HRs (95% CIs) for the 2nd and 3rd tertile of omentin compared with the 1st tertile were: 1.24 (95% CI 0.86, 1.79) and 1.63 (1.15, 2.32) (ptrend = 0.005) for the composite cardiovascular endpoint; 1.39 (0.78, 2.47) and 1.71 (0.98, 2.99) (ptrend = 0.065) for incident myocardial infarction; 1.40 (0.78, 2.53) and 2.05 (1.17, 3.58) (ptrend = 0.010) for incident stroke; and 1.43 (0.85, 2.40) and 1.72 (1.04, 2.83) (ptrend = 0.040) for cardiovascular death. Effect estimates and p values were almost unaltered after additional adjustment for adiponectin. CONCLUSIONS/INTERPRETATION Higher omentin concentrations are associated with an increased risk for cardiovascular events in individuals with diabetes after adjustment for multiple cardiovascular risk factors. Given data from preclinical studies, it appears possible that this association reflects a compensatory, but insufficient upregulation of omentin concentrations as a response to stimuli that increase cardiovascular risk.

中文翻译：

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较高的循环网膜蛋白与糖尿病患者发生原发性心血管事件的风险增加相关。

目的/假设在实验和横断面研究中，较高浓度的脂肪因子网膜蛋白与较低的心血管代谢危险因素相关，但在基于人群的队列研究中，与2型糖尿病和心血管疾病的风险较高相关。然而，尚不清楚高网膜蛋白浓度是否与确诊的糖尿病患者发生心血管事件的风险增加相关。因此，本研究调查了血清omentin浓度与糖尿病患者发生心血管事件的风险之间的关系。方法这项前瞻性研究是基于德国ESTHER队列中患有糖尿病且未曾发生心血管事件的参与者进行的。ESTHER队列由基线的50-75岁的个体组成，这些个体是由其全科医生招募的。排除血清C反应蛋白≥10mg / l（≥95.24nmol / l）的个体后，最终分析人群包括933个人。在基线时，通过ELISA测量血清omentin浓度。拟合Cox回归模型来估计网膜蛋白三分位数与心血管事件的复合终点以及事件性心肌梗塞，中风和心血管死亡的关联的HR和其相应的95％CI。结果在14年的随访中，有228人经历了一次主要的心血管事件（心肌梗塞，中风或心血管死亡）。在对年龄，性别，BMI，代谢和生活方式因素以及用药情况进行综合调整后，网膜蛋白第二和第三三分位数与第一三分位数的心率（95％CI）分别为：1.24（95％CI 0.86、1.79）和1.63。 （1.15，2。32）（ptrend = 0.005）用于复合心血管终点；心肌梗塞事件的发生率分别为1.39（0.78，2.47）和1.71（0.98，2.99）（ptrend = 0.065）; 入射冲程为1.40（0.78，2.53）和2.05（1.17，3.58）（ptrend = 0.010）; 心血管死亡分别为1.43（0.85，2.40）和1.72（1.04，2.83）（ptrend = 0.040）。进一步调整脂联素后，效果估计值和p值几乎保持不变。结论/解释在调整了多种心血管危险因素后，较高的网膜蛋白浓度与糖尿病患者发生心血管事件的风险增加相关。根据临床前研究的数据，这种关联似乎反映出代偿性的网膜蛋白浓度上调，但对增加心血管风险的刺激反应不足。