High free fatty acid concentration:: an independent risk factor for hypertension in the Paris Prospective Study
High free fatty acid concentration:: an independent risk factor for hypertension in the Paris Prospective Study
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DOI：
10.1093/ije/27.5.808
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发表时间：
1998-10-01
影响因子：
7.7
通讯作者：
Eschwège, E
中科院分区：
文献类型：
--
作者：
Fagot-Campagna, A;Balkau, B;Eschwège, E
背景资料。据报道，胰岛素和高血压发病率之间存在不一致的关系。游离脂肪酸与胰岛素抵抗有关，可能对高血压有直接影响。我们考察了游离脂肪酸对高血压发病率的影响，并考虑了胰岛素抵抗综合征的其他异常。方法总共对2968名非高血压和非糖尿病的高加索男性进行了3年的跟踪调查。高血压的发生率定义为收缩压(SBP)大于或等于160 mm Hg或舒张压(DBP)大于或等于95 mm Hg或高血压药物治疗。结果控制年龄、高血压家族史、饮酒、体重指数、髂围和体重变化后，游离脂肪酸升高是高血压的显著危险因素。进一步控制SEP、心率、空腹胰岛素和血糖并不降低其预测能力(危险比[RR]=1.58，95%可信区间[CI]：禁食时第90个百分位数与板条百分位数比较1.30~1.91；空腹时RR=1.54，95%CI：1.33~1.79)。在控制了年龄、高血压家族史、饮酒和体感诱发电位的前向逐步模型中，解释高血压发生的变量依次是体重变化、2 h游离脂肪酸、髂围和空腹游离脂肪酸，而体重指数、心率、胰岛素、血糖和其他血脂没有进入模型。结论在控制了所有已知的胰岛素抵抗综合征危险因素和其他异常因素后，游离脂肪酸升高是高血压的危险因素。这些结果突出了使用游离脂肪酸氧化抑制剂治疗的可能好处。
Background. An inconsistent relationship has been reported between insulin and hypertension incidence. Free fatty acids are related to insulin-resistance and may have a direct effect on hypertension. We examined the effect of free fatty acids on hypertension incidence, taking into account other abnormalities of the insulin-resistance syndrome.Methods In all, 2968 non-hypertensive and non-diabetic Caucasian men were followed for 3 years. Hypertension incidence was defined as systolic blood pressure (SBP) greater than or equal to 160 mmHg or diastolic blood pressure(DBP) greater than or equal to 95 mmHg or drug treatment for hypertension.Results Free fatty acid elevation was a highly significant risk factor for hypertension when controlled for age, family history of hypertension, alcohol consumption, body mass index, iliac circumference and weight change. Further controlling for SEP, heart rate and fasting insulin and glucose did not decrease its predictive power (hazard rate ratio [RR] = 1.58, 95% confidence interval [CI] : 1.30-1.91 comparing the 90th to the lath percentiles at fasting; RR = 1.54, 95% CI: 1.33-1.79 at 2 h). In a forward stepwise model controlled for age, family history of hypertension, alcohol consumption and SEP, the selected variables explaining the occurrence of hypertension were, in order, weight change, 2-h free fatty acids, iliac circumference and fasting free fatty acids, whereas body mass index, heart rate, insulin, glucose and other lipids did not enter into the model.Conclusions Free fatty acids elevation, when controlled for all known risk factors and other abnormalities of the insulin-resistance syndrome, is a risk factor for hypertension. These results highlight the possible benefits of treatment using free fatty acid oxidation inhibitors.