Cross-sectional associations of resistin, coronary heart disease, and insulin resistance

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.