Does leptin predict incident hypertension in older adults?
Does leptin predict incident hypertension in older adults?
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DOI：
10.1111/j.1365-2265.2010.03781.x
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发表时间：
2010-08-01
影响因子：
3.2
通讯作者：
Barrett-Connor, Elizabeth
中科院分区：
文献类型：
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作者：
Kramer, Caroline K.;von Muehlen, Denise;Barrett-Connor, Elizabeth
在实验和横断面研究中，瘦素与血压（BP）相关，但只有一项先前的中年男性前瞻性研究报道了瘦素与高血压之间的关系。我们在一项以老年男性和女性为研究对象的人群研究中，研究了瘦素水平与高血压发病率的关系。设计纵向队列研究。研究对象为602名基线血压水平正常的社区老年人，他们在1984年至1987年期间参加了一项研究诊所的访问，4年后又参加了一次4中心点的访问（平均年龄为66中心点2 +/- 11中心点4; 60中心点6%为男性;平均体重指数（BMI）24中心点9 +/-3中心点4 kg/m2）。测量高血压定义为收缩压≥ 140 mmHg和/或舒张压≥ 90 mmHg和/或或抗高血压药物治疗。瘦素测定放射免疫法。结果经过平均4个中心点4年的随访（最小2-最大7年），106（17个中心点6%）新的高血压病例被确定。基线时，与血压正常的参与者相比，发生高血压的参与者年龄较大，收缩压和总胆固醇较高。基线血清瘦素水平在高血压患者中高于持续性血压正常者[中位数（25 - 75范围）] [8中心点8（5-16）vs 7（4-11）ng/ml，P = 0中心点002]。在Logistic回归模型中，瘦素（对数转换）预测高血压事件之前和之后的基线年龄，BMI，收缩压，总胆固醇，药物治疗，和以前的心血管疾病（OR 1中心点75 95% CI 1中心点17-2中心点61，P = 0中心点006）调整。排除45肥胖participator.ConclusionHigher瘦素水平与老年人高血压发病几率增加独立相关。
P>ObjectiveLeptin is associated with blood pressure (BP) in experimental and cross-sectional studies, but only one previous prospective study of middle-aged men has reported the association between leptin and incident hypertension. We examined the association of leptin levels with incident hypertension in a population-based study of older men and women.DesignLongitudinal cohort study.PopulationParticipants were 602 community-dwelling older adults with normal baseline BP levels who attended a research clinic visit between 1984 and 1987 and again 4 center dot 4 years later (mean age was 66 center dot 2 +/- 11 center dot 4; 60 center dot 6% were men; mean body mass index (BMI) 24 center dot 9 +/- 3 center dot 4 kg/m2).MeasurementsHypertension was defined as systolic BP >= 140 mmHg and/or diastolic BP >= 90 mmHg and/or antihypertensive drug treatment. Leptin was measured by radioimmunoassay.ResultsAfter an average 4 center dot 4-year follow-up (minimum 2-maximum 7 years), 106 (17 center dot 6%) new cases of hypertension were identified. At baseline, participants who developed hypertension were older and had higher systolic BP and higher total cholesterol compared to participants who remained normotensive. Baseline serum leptin levels were higher in participants who developed hypertension compared to persistent normotensives [median (25th-75th range)] [8 center dot 8(5-16) vs 7(4-11) ng/ml, P = 0 center dot 002]. In logistic regression models, leptin (log-transformed) predicted incident hypertension before and after adjustments for baseline age, BMI, systolic BP, total cholesterol, medications, and previous cardiovascular disease (OR 1 center dot 75 95% CI 1 center dot 17-2 center dot 61, P = 0 center dot 006). This association persisted after exclusion of 45 obese participants.ConclusionHigher leptin levels were independently associated with increased odds of incident hypertension in older adults.