Department of Internal Medicine University of Pisa, Via Roma 67, Pisa I-56100, Italy.
Cardiovasc Diabetol. 2012 Aug 31;11:103. doi: 10.1186/1475-2840-11-103.
Endothelial dysfunction is an independent risk factor for cardiovascular events. Inflammatory mediators released by the adipose tissue can lead to local insulin resistance and endothelial dysfunction. This study addressed the relationship of adipocytokines with endothelial function and blood pressure.
In 92 newly diagnosed, drug-naïve essential hypertensive patients (HT, mean age 49 yrs) without organ damage and 66 normotensive subjects (NT, mean age 47 yrs), by an automated system, we measured endothelium-dependent and -independent vasodilation as brachial artery flow-mediated dilation before and after administration of glyceryl-trinitrate. Retinol binding protein-4 (RBP4) and resistin levels were determined by ELISA and RIA, respectively. Oxidative stress was evaluated by measuring serum malondyaldehyde (MDA).
Flow-mediated dilation was significantly (p = 0.03) lower in HT (5.3 ± 2.6%) than NT (6.1 ± 3.1%), while response to glyceryl-trinitrate (7.5 ± 3.7% vs 7.9 ± 3.4%) was similar. RBP4 (60.6 ± 25.1 vs 61.3 ± 25.9 μg/ml), resistin (18.8 ± 5.3 vs 19.9 ± 6.1 ng/ml) and MDA levels (2.39 ± 1.26 vs 2.08 ± 1.17 nmol/ml) were not different in HT and NT.RBP4 (r = -0.25; p = 0.04) and resistin levels (r = -0.29; p = 0.03) were related to flow-mediated dilation in NT, but not in HT (r = -0.03 and r = -0.10, respectively). In NT, multivariate analysis including RBP4 and confounders showed that only BMI or waist circumference remained related to flow- mediated dilation. In the multivariate model including resistin and confounders, BMI, age and resistin were significantly related to flow-mediated dilation, while only age significant correlated with this parameter when BMI was replaced by waist circumference.
Adipocytokine levels may be independent predictors of endothelial dysfunction in the peripheral circulation of healthy subjects, providing a pathophysiological link between inflammation from adipose tissue and early vascular alterations.
内皮功能障碍是心血管事件的独立危险因素。脂肪组织释放的炎症介质可导致局部胰岛素抵抗和内皮功能障碍。本研究旨在探讨脂肪细胞因子与内皮功能和血压的关系。
在 92 例新诊断的、未经药物治疗的原发性高血压患者（HT，平均年龄 49 岁）和 66 例血压正常的受试者（NT，平均年龄 47 岁）中，采用自动系统测量肱动脉血流介导的舒张功能，分别在给予甘油三硝酸酯前后测量内皮依赖性和非依赖性血管舒张。采用 ELISA 和 RIA 分别测定视黄醇结合蛋白-4（RBP4）和抵抗素水平。通过测量血清丙二醛（MDA）评估氧化应激。
与 NT（6.1±3.1%）相比，HT（5.3±2.6%）的血流介导的舒张明显降低（p=0.03），而对甘油三硝酸酯的反应（7.5±3.7%对 7.9±3.4%）相似。RBP4（60.6±25.1 对 61.3±25.9 μg/ml）、抵抗素（18.8±5.3 对 19.9±6.1 ng/ml）和 MDA 水平（2.39±1.26 对 2.08±1.17 nmol/ml）在 HT 和 NT 中无差异。RBP4（r=-0.25；p=0.04）和抵抗素水平（r=-0.29；p=0.03）与 NT 中的血流介导的舒张相关，但在 HT 中无相关性（r=-0.03 和 r=-0.10）。在包括 RBP4 和混杂因素的多元分析中，仅 BMI 或腰围与血流介导的舒张有关。在包括抵抗素和混杂因素的多元模型中，BMI、年龄和抵抗素与血流介导的舒张显著相关，而当 BMI 被腰围取代时，仅年龄与该参数显著相关。
脂肪细胞因子水平可能是健康受试者外周循环内皮功能障碍的独立预测因子，为脂肪组织炎症与早期血管改变之间的病理生理联系提供了依据。
