Role of adiponectin in insulin-resistant hypertension and atherosclerosis.
Role of adiponectin in insulin-resistant hypertension and atherosclerosis.
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DOI：
10.1291/hypres.26.705
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发表时间：
2003-09
期刊：
影响因子：
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通讯作者：
H. Murakami;N. Ura;M. Furuhashi;K. Higashiura;T. Miura;K. Shimamoto
中科院分区：
文献类型：
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作者：
H. Murakami;N. Ura;M. Furuhashi;K. Higashiura;T. Miura;K. Shimamoto
胰岛素抵抗是高血压和动脉粥样硬化发生的主要危险因素之一。最近的研究表明，脂联素（一种脂肪细胞衍生的激素）可能参与糖尿病患者的胰岛素抵抗和动脉粥样硬化的发展。本研究的目的是根据日本流行病学调查的结果，检测原发性高血压患者的脂联素水平，以确定脂联素水平与胰岛素敏感性之间的关系，并检查普通人群中脂联素与脉搏波速度（PWV）的关系。在一项临床研究中，20例正常血压患者（NT）和30例未治疗的原发性高血压患者（EHT）住院，并进行了血糖-高胰岛素-葡萄糖钳夹（GC）评估胰岛素敏感性，以M值定义。以NT M值的均值-1 SD为分界点，将EHT分为胰岛素抵抗型EHT （EHT- r）和胰岛素非抵抗型EHT （EHT- n）。测定空腹血糖（FPG）、免疫反应性胰岛素（IRI）和脂联素浓度。在NT、EHT-N和EHT-R组中，体重指数（BMI）和FPG没有显著差异。EHT-R组的M值和脂联素浓度显著低于NT和EHT-N组。EHT-R组的IRI水平明显高于其他组。所有受试者的脂联素浓度与M值均呈正相关，多元回归分析发现脂联素浓度与M值互为显著决定因素。在一项流行病学研究中，我们研究了日本北海道农村社区的391名男性居民。在清晨测量所有受试者的收缩压（SBP）、BMI、FPG、IRI和脂联素。计算稳态模型评估（HOMA）值作为胰岛素敏感性指标，PWV作为动脉粥样硬化指标。所有受试者的HOMA值与脂联素浓度呈负相关。多元回归分析显示，在70岁以下的受试者中，脂联素是PWV的重要决定因素。临床研究结果表明，EHT-R不仅存在高胰岛素血症，而且存在低脂联素浓度。利用流行病学研究数据对PWV程度的决定因素进行多元回归分析的结果表明，脂联素在抗动脉粥样硬化中发挥作用，部分通过改善胰岛素抵抗。
Insulin resistance is one of the major risk factors associated with development of hypertension and atherosclerosis. Recent studies have shown that adiponectin, an adipocyte-derived hormone, may be involved in insulin resistance and development of atherosclerosis in diabetes patients. The aim of this study was to examine adiponectin levels in patients with essential hypertension to determine the relationships between adiponectin levels and insulin sensitivity and to examine the relationship of adiponectin with pulse wave velocity (PWV) in a general population based on the results of an epidemiological survey in Japan. In a clinical study, 20 normotensives (NT) and 30 non-treated essential hypertensives (EHT) were hospitalized, and euglycemic hyperinsulinemic glucose clamp (GC) was performed to evaluate insulin sensitivity defined as M value. EHT were divided into insulin-resistant EHT (EHT-R) and insulin-nonresistant EHT (EHT-N) according to the mean -1 SD of the M value of NT as a cut-off point. Fasting plasma glucose (FPG), immunoreactive insulin (IRI), and adiponectin concentrations were measured. There were no significant differences in body mass index (BMI) or FPG among the NT, EHT-N, and EHT-R groups. The M value and adiponectin concentration in EHT-R were significantly lower than those in the NT or EHT-N. The IRI level in the EHT-R was significantly higher than those in the other groups. A positive correlation between adiponectin concentration and M value was found in all subjects, and adiponectin concentration and M value were found to be significant determinants of each other in multiple regression analysis. In an epidemiological study, we studied 391 male inhabitants of rural communities in Hokkaido, Japan. Systolic blood pressure (SBP), BMI, FPG, IRI, and adiponectin were measured in all subjects early in the morning. Homeostasis model assessment (HOMA) values were calculated as an index of insulin sensitivity, and PWV was used as an index of atherosclerosis. A negative correlation between HOMA values and adiponectin concentration was found in all of the subjects. Multiple regression analysis revealed that adiponectin was a significant determinant for PWV in subjects less than 70 years of age. The results of the clinical study indicate that EHT-R had not only hyperinsulinemia but also a low concentration of adiponectin. The results of multiple regression analysis for determinants of degree of PWV using data obtained in the epidemiological study suggest that adiponectin plays a role in antiatherosclerosis, partly through improvement of insulin resistance.