Yilmaz Mahmut Ilker, Sonmez Alper, Kilic Selim, Celik Turgay, Bingol Necati, Pinar Murat, Mumcuoglu Tarkan, Ozata Metin
Department of Nephrology, Gülhane School of Medicine, 06 018 Etlik-Ankara, Turkey.
Eur J Endocrinol. 2005 Feb;152(2):233-40. doi: 10.1530/eje.1.01851.
Previous studies have demonstrated that low plasma adiponectin concentrations are associated with essential hypertension. It has also recently been shown that adiponectin plays an essential role in the modulation of angiogenesis. These data led us to hypothesize that adiponectin might contribute to end-organ damage in hypertension.
In the present study we have evaluated the relationship between plasma adiponectin concentrations and hypertensive retinopathy. One hundred and ten patients newly diagnosed with essential hypertension (EHT) (mean age, 46.79+/-5.0 years; body mass index (BMI), 26.47+/-2.23 kg/m(2); male/female ratio, 58/52) and 57 healthy normotensive control subjects (NT) (mean age, 46.84+/-5.4 years; BMI, 26.66+/-2.65 kg/m(2); male/female ratio, 33/24) were enrolled.
Plasma adiponectin levels were significantly lower in EHT than in NT (P < 0.001). In addition, adiponectin concentrations were strongly correlated with systolic and diastolic blood pressures in EHT (r = -0.757, P < 0.001; r = -0.761, P < 0.001) while there was no correlation in the NT group. Plasma adiponectin in patients with grade 0 hypertensive retinopathy (n = 52) was significantly higher than that of the patients with grade 1 (n = 30) and 2 (n = 28) hypertensive retinopathy (P < 0.001 for each). Plasma adiponectin in patients with grade 0 hypertensive retinopathy was also significantly lower than that in the NT group (P < 0.001). The estimated threshold of plasma adiponectin concentration for hypertensive retinopathy was 17 microg/ml. This critical adiponectin level served largely to separate patients with retinopathy from those without.
Our results have shown that plasma adiponectin concentrations decrease progressively with higher grades of hypertensive retinopathy even after correction for other atherogenic risk factors, suggesting that a critical adiponectin level is needed for the development of retinopathy.
既往研究表明，血浆脂联素浓度降低与原发性高血压相关。最近也有研究表明，脂联素在血管生成调节中起重要作用。这些数据使我们推测脂联素可能导致高血压患者的靶器官损害。
在本研究中，我们评估了血浆脂联素浓度与高血压视网膜病变之间的关系。纳入110例新诊断的原发性高血压（EHT）患者（平均年龄46.79±5.0岁；体重指数（BMI）26.47±2.23kg/m²；男女比例58/52）和57例健康血压正常的对照者（NT）（平均年龄46.84±5.4岁；BMI 26.66±2.65kg/m²；男女比例33/24）。
EHT患者的血浆脂联素水平显著低于NT组（P<0.001）。此外，EHT患者的脂联素浓度与收缩压和舒张压密切相关（r=-0.757，P<0.001；r=-0.761，P<0.001），而NT组无相关性。0级高血压视网膜病变患者（n=52）的血浆脂联素显著高于1级（n=30）和2级（n=28）高血压视网膜病变患者（每组P<0.001）。0级高血压视网膜病变患者的血浆脂联素也显著低于NT组（P<0.001）。高血压视网膜病变的血浆脂联素浓度估计阈值为17μg/ml。这个关键的脂联素水平在很大程度上用于区分有视网膜病变和无视网膜病变的患者。
我们的结果表明，即使校正其他动脉粥样硬化危险因素后，血浆脂联素浓度仍随着高血压视网膜病变等级的升高而逐渐降低，提示视网膜病变的发生需要一个关键的脂联素水平。
