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This version published online on December 5, 2006
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2006-1138
A more recent version of this article appeared on February 1, 2007
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Submitted on May 25, 2006
Accepted on November 27, 2006

Plasma Leptin Levels and Coronary Artery Calcification in Older Adults

Carlos Iribarren MD, MPH, PhD*, Gail Husson MPH, Med, Alan S. Go MD, Joan C. Lo MD, Joan M. Fair ANP, PhD, Geoffrey D. Rubin MD, Mark A. Hlatky MD, and Stephen P. Fortmann MD

Kaiser Permanente Division of Research, Oakland, CA; Departments of Epidemiology, Biostatistics, and Medicine, University of California, San Francisco, San Francisco, CA; Endocrinology and Metabolism Section, San Francisco General Hospital, Department of Medicine, University of California, San Francisco, San Francisco, CA; Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA; Department of Radiology, Stanford University School of Medicine, Stanford, CA; Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA

* To whom correspondence should be addressed. E-mail: cgi{at}dor.kaiser.org.

Context. Leptin is associated with adiposity and insulin resistance and may play a direct role in vascular calcification. It is unclear, however, whether leptin is an independent predictor of atherosclerotic burden.

Objective. To examine the association between plasma leptin and coronary artery calcification (CAC) in an ethnically diverse cohort of older adult men and women free of clinical cardiovascular disease.

Design. Cross-sectional study with data collection between January 2002 and February 2004 as part of the ADVANCE Study.

Setting. Integrated health care delivery system in Northern California.

Participants. 949 men and women aged 60-69 years old.

Intervention(s). None.

Main Outcome Measure. Coronary artery calcification by multi-detector row computed tomography.

Results. In ordinal logistic regression, plasma leptin levels were positively associated with extent of CAC independently of age race/ethnicity and smoking status in women (Odds Ratio [OR] of higher CAC for the sex-specific upper tertile vs. lower tertile=1.81 (95 percent confidence interval [CI], 1.10-3.00) but not in men (OR=1.29; 95 percent CI=0.89-1.86). However, this association was explained by metabolic risk factors and adiposity measures.

Conclusions. Our findings support a role of leptin on vascular calcification in women but, in our sample of older adults, the association between leptin and CAC was not independent of other cardiac risk factors.
Key words: Leptin • Coronary Artery Calcification • Epidemiology • Risk Factors




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