非糖尿病原发性高血压患者中脂联素与I型前胶原羧基末端前肽的关联

Association of adiponectin with procollagen type I carboxyterminal propeptide in non-diabetic essential hypertension.

作者信息

Tsai Wei-Chuan, Lin Chih-Chan, Chen Ju-Yi, Huang Yao-Yi, Lee Cheng-Han, Li Wei-Ting, Weng Chiung-Mei, Chen Jyh-Hong

机构信息

Department of Internal Medicine, National Cheng Kung University Hospital Dou-Liou Branch, Dou-Liou, Taiwan.

出版信息

Blood Press. 2008;17(4):233-8. doi: 10.1080/08037050802308895.

DOI:10.1080/08037050802308895

PMID:18671144

Abstract

OBJECTIVE

The serum concentration of procollagen type I carboxyterminal propeptide (PICP) is a good marker for collagen deposition in hypertension. Increased collagen deposition was associated with myocardial fibrosis and increased arterial stiffness. A decreased adiponectin level is associated with increased atherosclerosis. The role of adiponectin and its relation to PICP in essential hypertension have rarely been studied before.

METHODS

We recruited 188 non-diabetic uncomplicated hypertensive patients (mean age: 41+/-7 years; 128 men). No patient had vascular complications or renal or liver diseases. Overnight fasting blood samples were collected to assess patient lipid profiles, blood sugar, insulin, high-sensitivity C-reactive protein (hsCRP), PICP and adiponectin. Carotid to radial pulse wave velocity (PWV) measured using tonometry was used as an index of arterial stiffness.

RESULTS

Adiponectin (r = -0.216, p = 0.003) and male gender (p<0.001) were independent determinants of PICP. Diastolic blood pressure (r = 0.422, p<0.001) and current smoking (p = 0.005) were independent determinants of PWV. PWV was significantly correlated with PICP (r = 0.156, p = 0.034). Adiponectin was significantly correlated with triglyceride (r = -0.276, p<0.001), high-density lipoprotein (r = 0.262, p<0.001), the homeostasis model assessment (HOMA) index (r = -0.220, p = 0.002), hsCRP (r = -0.207, p = 0.004) and the body mass index (BMI) (r = -0.202, p = 0.005). After compensation with possible confounding factors, adiponectin was still significantly correlated with PICP (beta = -0.196, p = 0.006).

CONCLUSION

Serum adiponectin may be a marker for metabolic syndrome in essential hypertension. Adiponectin was significantly negatively correlated with PICP. Metabolic syndrome probably plays an important role in increased collagen synthesis and arterial stiffness through the effects of decreased adiponectin in non-diabetic essential hypertension.

摘要

目的

血清I型前胶原羧基末端前肽（PICP）浓度是高血压中胶原沉积的良好标志物。胶原沉积增加与心肌纤维化和动脉僵硬度增加相关。脂联素水平降低与动脉粥样硬化增加相关。脂联素在原发性高血压中的作用及其与PICP的关系此前鲜有研究。

方法

我们招募了188例非糖尿病的单纯高血压患者（平均年龄：41±7岁；128例男性）。所有患者均无血管并发症或肾、肝疾病。采集过夜空腹血样以评估患者的血脂谱、血糖、胰岛素、高敏C反应蛋白（hsCRP）、PICP和脂联素。使用眼压计测量的颈-桡脉搏波速度（PWV）用作动脉僵硬度指标。

结果

脂联素（r = -0.216，p = 0.003）和男性性别（p<0.001）是PICP的独立决定因素。舒张压（r = 0.422，p<0.001）和当前吸烟情况（p = 0.005）是PWV的独立决定因素。PWV与PICP显著相关（r = 0.156，p = 0.034）。脂联素与甘油三酯（r = -0.276，p<0.001）、高密度脂蛋白（r = 0.262，p<0.001）、稳态模型评估（HOMA）指数（r = -0.220，p = 0.002）、hsCRP（r = -0.207，p = 0.004）和体重指数（BMI）（r = -0.202，p = 0.005）显著相关。在对可能的混杂因素进行校正后，脂联素仍与PICP显著相关（β = -0.196，p = 0.006）。