In order to investigate the relationship between plasma levels of inflammatory markers and the prevalence of coronary artery calcification (CAC), as measured by beam tomography, Qasim et al. performed cross-sectional analyses in the Study of Inherited Risk of Coronary Atherosclerosis (SIRCA), which included 457 men (median age = 46 years) and 403 women (median age = 50 years). The inflammatory markers of interest were leptin and adiponectin. After adjusting for age, gender, race, family history, exercise, medications, and Framingham risk score, the combined ratio in the Tobit multivariate model (top vs. bottom quartile of leptin levels and bottom vs. top quartile of adiponectin levels) was 1.28 (95% CI, 0.79-2.07) for adiponectin and 3.77 (95% CI, 2.31-6.14) for leptin. After further adjustment for the metabolic syndrome and plasma C-reactive protein (CRP) levels, the combined ratios were 1.47 (95% CI, 0.89-2.41) and 2.31 (95% CI, 1.36-3.94), respectively, for adiponectin and leptin. In addition to leptin, the homeostatic model assessment of insulin resistance as well as plasma levels of interleukin-6 and soluble tumor necrosis factor receptor-2 were associated with CAC, independent of the metabolic syndrome and plasma CRP levels. Based on these results, the authors concluded that not only the pathways linking leptin and CAC need to be clarified, but also the relationship between leptin levels and other circulating biomarkers in terms of cardiovascular disease risk prediction.
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