Papadopoulos D P, Makris Th K, Perrea D, Papazachou O, Daskalaki M, Sanidas E, Votteas V
Hypertension Clinic, Department of Cardiology, Laiko Hospital, Athens, Greece.
Blood Press. 2008;17(1):50-4. doi: 10.1080/08037050701876307.
Accumulating epidemiological studies have shown that healthy offspring of hypertensive patients exhibit some metabolic disturbances such as hyperinsulinemia, insulin resistance, lipid disorders, elevated plasma leptin levels and reduced insulin receptor number, features that may be predictors of future cardiovascular events. The aim of this study was to determine insulin, adiponectin and resistin plasma levels in young healthy offspring of patients with essential hypertension, and to compare the findings to those of young healthy offspring of healthy normotensives matched for age, sex and body mass index (BMI).
Forty-six (24 male/22 female) healthy offspring of patients with essential hypertension-positive family history (FH+), mean age 18+/-3 years and BMI 22.4+/-1.4 kg/m2 (group A) and 50 (28 male/22 female) healthy offspring of healthy normotensives-negative family history (FH-) mean age 18+/-3.2 years and BMI 22.6+/-1.7 kg/m2 (group B) were studied. The two groups were matched for age, sex and BMI. Systolic and diastolic blood pressure (SBP and DBP) measurements, resting heart rate (HR), plasma insulin (RIA method), adiponectin and resistin plasma levels (ELISA) were determined in the whole study population.
Mean SBP, DBP and resting HR were significantly higher in group A compared with group B (121+/-13 vs 110+/-10 mmHg, 78+/-6 vs 73+/-8 mmHg, 76+/-4 vs 72+/-6 beats/min, p<0.01, p<0.05 and p<0.01 respectively). Insulin and resistin plasma levels were significantly higher, while adiponectin levels were significantly lower. In group A compared with group B (21+/-7 vs 15+/-6 pIU/ml, 10+/-5 vs 6+/-3 ng/ml, 20+/-5 vs 29+/-8 microg/ml, p<0.01, p<0.01, p<0.01, respectively).
Our findings suggest that increased SBP, DBP and resting HR as well as increased insulin and resistin plasma levels and decreased adiponectin plasma levels pre-exist in young healthy offspring with positive family history for essential hypertension. Further studies are needed to determine the clinical significance of these observations in attempt to classify these young healthy individuals for future cardiovascular risk.
越来越多的流行病学研究表明，高血压患者的健康后代存在一些代谢紊乱，如高胰岛素血症、胰岛素抵抗、脂质紊乱、血浆瘦素水平升高和胰岛素受体数量减少，这些特征可能是未来心血管事件的预测指标。本研究的目的是测定原发性高血压患者年轻健康后代的胰岛素、脂联素和抵抗素血浆水平，并将结果与年龄、性别和体重指数（BMI）相匹配的健康血压正常者的年轻健康后代进行比较。
研究了46名（24名男性/22名女性）原发性高血压阳性家族史（FH+）患者的健康后代，平均年龄18±3岁，BMI为22.4±1.4kg/m²（A组）和50名（28名男性/22名女性）健康血压正常者阴性家族史（FH-）的健康后代，平均年龄18±3.2岁，BMI为22.6±1.7kg/m²（B组）。两组在年龄、性别和BMI方面相匹配。在整个研究人群中测定收缩压和舒张压（SBP和DBP）、静息心率（HR）、血浆胰岛素（放射免疫分析法）、脂联素和抵抗素血浆水平（酶联免疫吸附测定法）。
A组的平均SBP、DBP和静息HR显著高于B组（分别为121±13 vs 110±10mmHg、78±6 vs 73±8mmHg、76±4 vs 72±6次/分钟，p<0.01、p<0.05和p<0.01）。A组的胰岛素和抵抗素血浆水平显著较高，而脂联素水平显著较低。与B组相比，A组分别为21±7 vs 15±6 pIU/ml、10±5 vs 6±3 ng/ml、20±5 vs 29±8 μg/ml，p<0.01、p<0.01、p<0.01）。
我们的研究结果表明，原发性高血压阳性家族史的年轻健康后代中，SBP、DBP和静息HR升高，以及胰岛素和抵抗素血浆水平升高和脂联素血浆水平降低在早期就已存在。需要进一步研究来确定这些观察结果的临床意义，以便对这些年轻健康个体未来的心血管风险进行分类。
