Serum Cortisol-to-Cortisone Ratio and Blood Pressure in Severe Obesity before and after Weight Loss
Serum Cortisol-to-Cortisone Ratio and Blood Pressure in Severe Obesity before and after Weight Loss
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DOI：
10.1159/000438462
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发表时间：
2015-09
影响因子：
3.8
通讯作者：
James Brian Byrd;A. Rothberg;Robert Chomic;C. Burant;R. Brook;R. Auchus
中科院分区：
文献类型：
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作者：
James Brian Byrd;A. Rothberg;Robert Chomic;C. Burant;R. Brook;R. Auchus
背景/目的：肥胖相关高血压的发病机制知之甚少。血清皮质醇与可的松比率（F/E比率）是皮质醇代谢的标志物。我们的目的是确定血清F/E比值是否与体重显著减轻（相对于基线体重≥15%）后的患者的血压（BP）相关。方法：43名非糖尿病，严重肥胖的男性参与体重管理计划的血清中的F和E进行了测定质谱。我们评估了伴随体重减轻的F/E比值的变化是否与收缩压（SBP）和舒张压（DBP）的变化相关。使用线性回归评估F/E比值的变化作为BP变化的预测因子。结果如下：体重指数从40.8 ± 5.6降至33.7 ± 4.8（p < 0.001）;此外，研究期间SBP（133.2 ± 13.8 vs. 124.1 ± 14.3 mm Hg; p < 0.001）和DBP（69.8 ± 8.0 vs. 66.6 ± 9.4 mm Hg; p = 0.026）降低。基线F/E比往往与基线DBP相关（斯皮尔曼的r =-0.29，p = 0.06），血清F/E比的变化与DBP的变化相关（斯皮尔曼的r =-0.32，p = 0.036）。F/E比值的变化也倾向于与SBP的变化相关（斯皮尔曼r =-0.27，p = 0.08）。校正F/E比值和年龄变化的多元线性回归模型解释了SBP变化的22%（R2 = 0.22，p = 0.007）。F/E比值的变化独立预测SBP的变化（p = 0.036）。结论：在我们的非糖尿病严重肥胖男性样本中，血清F/E比值的变化与体重减轻后血压的变化相关。
Background/Aims: The pathogenesis of obesity-associated hypertension is poorly understood. Serum cortisol-to-cortisone ratio (F/E ratio) is a marker of cortisol metabolism. Our objective was to determine whether the serum F/E ratio is associated with blood pressure (BP) in patients after significant weight loss (≥15% from baseline weight). Methods: Sera from 43 nondiabetic, severely obese males participating in a weight management program were assayed for F and E by mass spectrometry. We assessed whether changes in the F/E ratio accompanying weight loss correlate with changes in the systolic (SBP) and diastolic BP (DBP). Linear regression was used to evaluate change in the F/E ratio as a predictor of change in BP. Results: The body mass index decreased from 40.8 ± 5.6 to 33.7 ± 4.8 (p < 0.001); also, SBP (133.2 ± 13.8 vs. 124.1 ± 14.3 mm Hg; p < 0.001) and DBP (69.8 ± 8.0 vs. 66.6 ± 9.4 mm Hg; p = 0.026) decreased during the study. The baseline F/E ratio tended to associate with baseline DBP (Spearman's r = -0.29, p = 0.06), and change in the serum F/E ratio correlated with change in DBP (Spearman's r = -0.32, p = 0.036). Change in the F/E ratio also tended to associate with change in SBP (Spearman's r = -0.27, p = 0.08). A multiple linear regression model adjusted for change in the F/E ratio and age explained 22% of the variance in SBP change (R2 = 0.22, p = 0.007). Change in the F/E ratio independently predicted change in SBP (p = 0.036). Conclusion: In our sample of nondiabetic, severely obese males, change in the serum F/E ratio was associated with change in BP after weight loss.