Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China.
Hypertens Res. 2012 May;35(5):513-7. doi: 10.1038/hr.2011.229. Epub 2012 Jan 26.
To explore the co-effects of inflammation and endothelial dysfunction and insulin resistance (IR) on hypertension in a large Asian population. Data on demographic characteristics, blood pressure and other variables were collected; additionally, fasting plasma glucose, insulin and biomarkers, including C-reactive protein (CRP), soluble intercellular cell adhesion molecule-1 (sICAM-1), soluble E-selectin (sE-selectin) and angiotensin II were examined among 2553 Mongolian adults aged ≥ 20 years. IR was assessed using the homeostasis model. The co-effects of elevated biomarkers of inflammation and endothelial dysfunction and IR on hypertension were analyzed. A total of 953 subjects were diagnosed with hypertension. Among hypertensive subjects, the levels of CRP (11.0 vs. 6.7 mg l(-1)), sICAM-1 (348.3 vs. 335.9 ng ml(-1)), sE-selectin (20.9 vs. 18.5 ng ml(-1)) and angiotensin II (61.3 vs. 50.0 pg ml(-1)) were significantly higher among subjects with IR than those without IR; among normotensives, levels of CRP (6.3 vs. 5.2 mg l(-1)) and sE-selectin (20.1 vs. 17.8 ng ml(-1)) were higher among IR subjects than those without IR. The prevalence of hypertension was significantly higher among subjects with IR and 2 elevated biomarkers (69.0%) and those with IR and ≥ 3 elevated biomarkers (79.3%) than among those with IR and no elevated biomarkers (45.9%) and those with IR and 1 elevated biomarker (50.6%). After adjusting for multivariate, the risk of hypertension was significantly associated with the coexistence of IR and any two or three elevated biomarkers (odds ratios (OR) (95% confidence intervals (CIs)) = 2.55 (1.60-4.06) and 3.19 (1.15-8.86), respectively). In this Mongolian population, IR and elevated biomarkers of inflammation and endothelial dysfunction were related to hypertension and the coexistence of IR and elevated biomarkers of inflammation and endothelial dysfunction increased the risk of hypertension.
探讨炎症和内皮功能障碍及胰岛素抵抗（IR）在亚洲人群中对高血压的共同作用。收集人口统计学特征、血压和其他变量的数据；此外，在 2553 名年龄≥20 岁的蒙古成年人中，检查空腹血浆葡萄糖、胰岛素和生物标志物，包括 C 反应蛋白（CRP）、可溶性细胞间黏附分子-1（sICAM-1）、可溶性 E 选择素（sE-选择素）和血管紧张素 II。使用稳态模型评估 IR。分析炎症和内皮功能障碍及 IR 升高的生物标志物对高血压的共同作用。共诊断 953 例高血压患者。在高血压患者中，IR 组 CRP（11.0 比 6.7mg/L）、sICAM-1（348.3 比 335.9ng/ml）、sE-选择素（20.9 比 18.5ng/ml）和血管紧张素 II（61.3 比 50.0pg/ml）水平显著高于非 IR 组；在血压正常者中，IR 组 CRP（6.3 比 5.2mg/L）和 sE-选择素（20.1 比 17.8ng/ml）水平高于非 IR 组。IR 伴 2 种或 3 种生物标志物升高者（69.0%）、IR 伴≥3 种生物标志物升高者（79.3%）高血压患病率明显高于 IR 伴无生物标志物升高者（45.9%）和 IR 伴 1 种生物标志物升高者（50.6%）。经多变量调整后，高血压的发病风险与 IR 与任何两种或三种升高的生物标志物同时存在显著相关（比值比（OR）（95%置信区间（CI））=2.55（1.60-4.06）和 3.19（1.15-8.86））。在蒙古人群中，IR 和炎症及内皮功能障碍升高的生物标志物与高血压相关，IR 与炎症及内皮功能障碍升高的生物标志物同时存在增加了高血压的发病风险。
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