Delles Christian, Raff Ulrike, Mimran Albert, Fauvel Jean P, Ruilope Luis M, Schmieder Roland E
Department of Nephrology and Hypertension, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
Am J Hypertens. 2008 Dec;21(12):1330-6. doi: 10.1038/ajh.2008.297. Epub 2008 Nov 6.
Adiponectin is secreted by adipose tissue and may play a role in cardiovascular disease. We examined adiponectin levels in patients with type 2 diabetes who participated in the Telmisartan vs. Ramipril in Renal Endothelial Dysfunction (TRENDY) study.
A total of 87 patients were assessed at baseline and following 9 weeks treatment with the angiotensin-receptor blocker telmisartan (final dose, 80 mg; n = 45) or the angiotensin-converting enzyme inhibitor ramipril (final dose, 10 mg; n = 42). Adiponectin levels were measured in plasma by radioimmunoassay.
Adiponectin levels were inversely correlated with systolic (SBP; r = -0.240, P < 0.05) and diastolic (DBP; r = -0.227, P < 0.05) blood pressure at baseline and following treatment with telmisartan or ramipril (SBP: r = -0.228, P < 0.05; DBP: r = -0.286, P < 0.05). Changes in adiponectin levels were related to changes in SBP (r = -0.357, P < 0.01) and DBP (r = -0.286, P < 0.01). There was a significant increase in adiponectin levels in the telmisartan (0.68 (95% confidence interval (CI), 0.27 to 1.10) microg/ml, P < 0.01) but not in the ramipril group (0.17 (95% CI, -0.56 to 0.90) microg/ml, P = 0.67). Blood pressure reduction in the telmisartan group (DeltaSBP: -13.5 (95% CI, -17.0 to -10.0) mm Hg; DeltaDBP: -7.6 (95% CI, -9.8 to -5.3) mm Hg, each P < 0.001) was significantly (P < or = 0.01 for SBP and P < 0.01 for DBP) greater than in the ramipril group (DeltaSBP: -6.1 (95% CI, -6.2 to -2.0) mm Hg; DeltaDBP: -2.7 (95% CI, -5.0 to -0.5) mm Hg; P < 0.01 and P < 0.05, respectively).
Adiponectin is correlated with blood pressure in patients with type 2 diabetes. Whether increased adiponectin contributes to the blood pressure-lowering effect of telmisartan needs further study.
脂联素由脂肪组织分泌，可能在心血管疾病中发挥作用。我们在参与替米沙坦与雷米普利治疗肾内皮功能障碍（TRENDY）研究的2型糖尿病患者中检测了脂联素水平。
共87例患者在基线时以及接受血管紧张素受体阻滞剂替米沙坦（最终剂量80mg；n = 45）或血管紧张素转换酶抑制剂雷米普利（最终剂量10mg；n = 42）治疗9周后进行了评估。采用放射免疫分析法测定血浆中的脂联素水平。
在基线时以及接受替米沙坦或雷米普利治疗后，脂联素水平与收缩压（SBP；r = -0.240，P < 0.05）和舒张压（DBP；r = -0.227，P < 0.05）呈负相关（SBP：r = -0.228，P < 0.05；DBP：r = -0.286，P < 0.05）。脂联素水平的变化与SBP（r = -0.357，P < 0.01）和DBP（r = -0.286，P < 0.01）的变化相关。替米沙坦组脂联素水平显著升高（0.68（95%置信区间（CI），0.27至1.10）μg/ml，P < 0.01），而雷米普利组未升高（0.17（95%CI，-0.56至0.90）μg/ml，P = 0.67）。替米沙坦组的血压降低幅度（ΔSBP：-13.5（95%CI，-17.0至-10.0）mmHg；ΔDBP：-7.6（95%CI，-9.8至-5.3）mmHg，均P < 0.001）显著大于雷米普利组（ΔSBP：-6.1（95%CI，-6.2至-2.0）mmHg；ΔDBP：-2.7（95%CI，-5.0至-0.5）mmHg；分别为P < 0.01和P < 0.05）。
2型糖尿病患者中脂联素与血压相关。脂联素升高是否有助于替米沙坦的降压作用有待进一步研究。
