Sung Shih-Hsien, Chuang Shao-Yuan, Sheu Wayne Huey-Herng, Lee Wen-Jane, Chou Pesus, Chen Chen-Huan
Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Hypertens Res. 2008 Apr;31(4):633-40. doi: 10.1291/hypres.31.633.
The role of adiponectin, a marker of the metabolic syndrome, on the pathogenesis of hypertension in comparison with markers of adipose tissue mass (leptin) and inflammation (high-sensitivity C-reactive protein [hs-CRP]) remains to be clarified. The eligible study population consisted of 2,045 residents aged > or =40 years who had participated in a community-based survey and had complete data for serum adiponectin, leptin, and hs-CRP, and for whom homeostasis model assessment of insulin resistance (HOMA-IR) had been calculated from insulin and plasma glucose. Among all eligible participants, as well as in the subgroup of nondiabetic normotensives (blood pressure <140/90 mmHg and without antihypertensive medication), all three markers were significantly correlated with systolic blood pressure (negative correlation for adiponectin and positive correlations for leptin and hs-CRP). Among all participants, systolic blood pressure and the presence of hypertension were determined mainly by age, sex, body mass index, and waist circumference. None of the markers further contributed to the multivariate linear regression or logistic regression models. In contrast, adiponectin, but not leptin, hs-CRP, or HOMA-IR, was significantly associated with systolic blood pressure and the presence of pre-hypertension (blood pressure within 120-139/80-89 mmHg) after adjustment for age, sex, body mass index, and waist circumference in the nondiabetic normotensive subgroup. Similarly, adiponectin was independently associated with diastolic blood pressure in the nondiabetic normotensive subgroup but not in the whole population. In conclusion, adiponectin, but not leptin or hs-CRP, was independently associated with blood pressure in a nondiabetic normotensive subgroup.
脂联素作为代谢综合征的一个标志物，与脂肪组织量的标志物（瘦素）和炎症标志物（高敏C反应蛋白[hs-CRP]）相比，在高血压发病机制中的作用仍有待阐明。符合条件的研究人群包括2045名年龄≥40岁的居民，他们参与了一项基于社区的调查，拥有血清脂联素、瘦素和hs-CRP的完整数据，并且已根据胰岛素和血浆葡萄糖计算出胰岛素抵抗的稳态模型评估（HOMA-IR）。在所有符合条件的参与者中，以及在非糖尿病正常血压者亚组（血压<140/90 mmHg且未服用抗高血压药物）中，所有这三种标志物均与收缩压显著相关（脂联素呈负相关，瘦素和hs-CRP呈正相关）。在所有参与者中，收缩压和高血压的存在主要由年龄、性别、体重指数和腰围决定。没有一种标志物对多元线性回归或逻辑回归模型有进一步贡献。相比之下，在非糖尿病正常血压亚组中，在调整年龄、性别、体重指数和腰围后，脂联素而非瘦素、hs-CRP或HOMA-IR与收缩压和高血压前期（血压在120 - 139/80 - 89 mmHg之间）的存在显著相关。同样，脂联素在非糖尿病正常血压亚组中与舒张压独立相关，但在整个人群中并非如此。总之，在非糖尿病正常血压亚组中，脂联素而非瘦素或hs-CRP与血压独立相关。
