Wada Keiko, Yatsuya Hiroshi, Tamakoshi Koji, Otsukai Rei, Fujii Chie, Matsushita Kunihiro, Sugiura Kaichiro, Toyoshima Hideaki
Department of Public Health/Health Information Dynamic, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Hypertens Res. 2006 Jul;29(7):485-92. doi: 10.1291/hypres.29.485.
The results of previous studies on the relationship between leptin and blood pressure are discordant. We investigated to what extent the serum leptin level was related to blood pressure independent of the degree of insulin resistance. The subjects were 1916 men aged 34-69 years whose mean body mass index (BMI) was 23.0 kg/m2. Blood pressure was regressed by leptin concentrations with adjustments for age, BMI, insulin resistance, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, physical activity, drinking habits and smoking status. Leptin was associated with diastolic blood pressure (DBP) (standardized beta: 0.092, p = 0.003), but not with systolic blood pressure (SBP) (standardized beta: 0.035, p = 0.25), although insulin resistance was positively associated with both SBP and DBP (standardized beta: 0.175 for SBP, p < 0.001 and 0.114 for DBP, p < 0.001) among all subjects. After subjects were divided into those with normal blood pressure (SBP <130 mmHg and DBP <85 mmHg) and those with higher blood pressure, leptin was positively and significantly associated with DBP (standardized beta: 0.106, p = 0.012) independent of the degree of insulin resistance, but not with SBP (standardized beta: 0.064, p = 0.13) among subjects in the normal blood pressure range. Among the subjects with higher blood pressure, however, neither the association of leptin with SBP nor that of leptin with DBP was statistically significant. These findings suggest that leptin may maintain and increase arterial tone, resulting in the elevation of DBP only within normal blood pressure range. It is also likely that leptin is a physiological mediator--or at least a marker--of some degree of DBP elevation in obesity.
先前关于瘦素与血压关系的研究结果并不一致。我们调查了血清瘦素水平在多大程度上与血压相关，且独立于胰岛素抵抗程度。研究对象为1916名年龄在34 - 69岁之间的男性，其平均体重指数（BMI）为23.0kg/m²。通过对年龄、BMI、胰岛素抵抗、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、身体活动、饮酒习惯和吸烟状况进行校正后，用瘦素浓度对血压进行回归分析。瘦素与舒张压（DBP）相关（标准化β系数：0.092，p = 0.003），但与收缩压（SBP）无关（标准化β系数：0.035，p = 0.25），尽管在所有受试者中胰岛素抵抗与SBP和DBP均呈正相关（SBP的标准化β系数：0.175，p < 0.001；DBP的标准化β系数：0.114，p < 0.001）。在将受试者分为血压正常（SBP < 130mmHg且DBP < 85mmHg）和血压较高两组后，在血压正常范围内的受试者中，瘦素与DBP呈显著正相关（标准化β系数：0.106，p = 0.012），且独立于胰岛素抵抗程度，但与SBP无关（标准化β系数：0.064，p = 0.13）。然而，在血压较高的受试者中，瘦素与SBP以及瘦素与DBP之间的关联均无统计学意义。这些发现表明，瘦素可能维持并增加动脉张力，从而仅在正常血压范围内导致DBP升高。瘦素也很可能是肥胖中某种程度DBP升高的生理介质——或者至少是一个标志物。
