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Cross-Sectional Associations of Resistin, Coronary Heart Disease, and Insulin Resistance

MedStar Research Institute (M.S.B., J.M.D., R.J.A., B.V.H.), Washington, D.C. 20010; Children’s National Medical Center (J.M.D.), Washington, D.C. 20010; and British Heart Foundation Cardiovascular Research Centre (R.L.), University of Glasgow, Glasgow G11 6NT, United Kingdom

Address all correspondence and requests for reprints to: Mary Susan Burnett, Cardiovascular Research Institute, MedStar Research Institute, 108 Irving Street NW, Room 217, Washington, D.C. 20010. E-mail: Mary.s.burnett-miller{at}medstar.net.

Context: Recently, resistin was found to be present in atherosclerotic lesions in apoE^–/– mice. Resistin may be associated with inflammation and atherosclerosis in humans; however, the role of resistin in human disease remains controversial.

Objective: This study assesses cross-sectional relationships of resistin with coronary heart disease (CHD).

Design, Setting, and Participants: Blood samples from the third examination of the Strong Heart Study (SHS)—the largest study of CHD in American Indians—were used. Cases who had suffered previous myocardial infarction (n = 100) were selected randomly from the three SHS sites and matched for study site and sex with controls who had no history of cardiovascular disease (CHD or stroke) (n = 100).

Main Outcome Measure: Resistin levels by enzyme-linked immunosorbent assay method in cases and controls was the main outcome measure.

Results: Resistin levels were higher in cases than controls [median (interquartile range): 3.4 (2.5–4.7) vs. 2.8 (2.1–4.0) ng/ml; P = 0.003] and had univariate correlations with age (Spearman r = 0.21; P < 0.002), fasting insulin (r = 0.21; P = 0.003), insulin resistance by homeostasis model (r = 0.22; P = 0.04), albumin to creatinine ratio (r = 0.19; P = 0.01), and fibrinogen (r = 0.34; P < 0.0001). Cases were more likely to have diabetes (cases 67%; controls 41%; P < 0.0001) but had similar body mass index (cases 31.4 ± 5.4; controls 30.7 ± 6.3; P = 0.85). Resistin levels were higher in participants with established nephropathy (albumin to creatinine ratio >300 mg/g, n = 26) compared with those with normo- (n = 122) or microalbuminuria (n = 42). In multivariate analysis, nephropathy (P = 0.0013) but not previous myocardial infarction (P = 0.12) was significantly associated with resistin.

Conclusions: Resistin is not independently associated with CHD. Resistin is elevated in survivors of myocardial infarction; however, this reflects a novel association of raised resistin with diabetic nephropathy.

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