Hypoadiponectinemia as a predictor for the development of hypertension - A 5-year prospective study
Hypoadiponectinemia as a predictor for the development of hypertension - A 5-year prospective study
复制标题
DOI：
10.1161/hypertensionaha.107.086835
复制
发表时间：
2007-06-01
期刊：
影响因子：
8.3
通讯作者：
Lam, Karen S. L.
中科院分区：
文献类型：
--
作者：
Chow, Wing-Sun;Cheung, Bernard M. Y.;Lam, Karen S. L.
低循环水平的脂联素（一种具有胰岛素增敏、抗动脉粥样硬化和抗炎特性的脂肪因子）在高血压患者中被发现。补充脂联素可改善脂联素缺乏小鼠或肥胖、低脂联素血症高血压小鼠的高血压，提示脂联素在高血压中的病因学作用。在这项为期5年的前瞻性研究中，我们的目的是确定低脂联素血症是否可以预测非糖尿病中国队列中高血压的发展。从以人群为基础的香港心血管危险因素流行研究中招募了577名受试者（249名男性和328名女性），并进行了5年的前瞻性随访。在一项巢式病例对照研究中，研究了血清脂联素与高血压（坐位血压>= 140/90 mm Hg）发展的关系，该研究由70名在随访中出现高血压的受试者和140名年龄和性别匹配的对照组组成，这些对照组在基线和第5年血压均正常。在基线时，最低性别特异性特分位数的血清脂联素水平更可能与高血压相关（P = 0.003，与最高特分位数相比，在调整年龄、体重指数、空腹胰岛素和高敏c反应蛋白后）。在巢式病例对照研究中，在第5年，基线血清脂联素与平均动脉压（P < 0.001）、高敏c反应蛋白（P = 0.018）和体重指数（P = 0.004）一起是高血压事件的重要独立预测因子（P = 0.015；年龄调整）。基线血清脂联素水平处于最低性别分位数的正常血压受试者发生高血压的风险增加（校正优势比：2.76;95% ci: 1.06 ~ 7.16；与最高分位数相比P = 0.037）。我们的数据表明，低脂联素血症可能参与了人类高血压的发病机制。
Low circulating levels of adiponectin, an adipokine with insulin-sensitizing, antiatherogenic, and anti-inflammatory properties, are found in hypertensive patients. Adiponectin replenishment ameliorated hypertension in adiponectin-deficient mice or obese, hypertensive mice with hypoadiponectinemia, suggesting an etiologic role of adiponectin in hypertension. We aimed to determine, in this 5-year prospective study, whether hypoadiponectinemia could predict the development of hypertension in a nondiabetic Chinese cohort. A total of 577 subjects ( 249 men and 328 women) were recruited from the population-based Hong Kong Cardiovascular Risk Factor Prevalence Study and prospectively followed up for 5 years. The relationship of serum adiponectin with the development of hypertension ( sitting blood pressure >= 140/90 mm Hg) was investigated in a nested case-control study consisting of 70 subjects who had developed hypertension on follow-up and 140 age- and sex-matched control subjects who were normotensive both at baseline and at year 5. At baseline, serum adiponectin level in the lowest sex-specific tertile was more likely to be associated with hypertension ( P = 0.003 versus the highest tertile, after adjusting for age, body mass index, fasting insulin, and high-sensitivity C-reactive protein). At year 5, baseline serum adiponectin was a significant independent predictor of incident hypertension in the nested case-control study ( P = 0.015; age adjusted), together with mean arterial pressure ( P < 0.001), high-sensitivity C-reactive protein ( P = 0.018), and body mass index ( P = 0.004). Normotensive subjects with baseline serum adiponectin levels in the lowest sex-specific tertile had an increased risk of becoming hypertensive ( adjusted odds ratio: 2.76; 95% CIs: 1.06 to 7.16; P = 0.037 versus highest tertile). Our data suggest that hypoadiponectinaemia may be involved in the pathogenesis of hypertension in humans.