Allison M A, Jenny N S, McClelland R L, Cushman M, Rifkin D
Department of Family and Preventive Medicine, University of California-San Diego, La Jolla, CA, USA.
Department of Pathology, University of Vermont College of Medicine, Burlington, VT, USA.
J Hum Hypertens. 2015 Feb;29(2):127-33. doi: 10.1038/jhh.2014.40. Epub 2014 Jun 12.
Among obese individuals, increased sympathetic nervous system (SNS) activity results in increased renin and aldosterone production, as well as renal tubular sodium reabsorption. This study determined the associations between adipokines and selected measures of the renin-angiotensinogen-aldosterone system (RAAS). The sample consisted of 1970 men and women from the Multi-Ethnic Study of Atherosclerosis who were free of clinical cardiovascular disease at baseline and had blood assayed for adiponectin, leptin, plasma renin activity (PRA) and aldosterone. The mean age was 64.7 years and 50% were female. The mean (s.d.) PRA and aldosterone were 1.45 (0.56) ng ml(-1) and 150.1 (130.5) pg ml(-1), respectively. After multivariable adjustment, a 1-s.d. increment of leptin was associated with a 0.55 ng ml(-1) higher PRA and 8.4 pg ml(-1) higher aldosterone (P<0.01 for both). Although adiponectin was not significantly associated with PRA levels, the same increment in this adipokine was associated with lower aldosterone levels (-5.5 pg ml(-1), P=0.01). Notably, the associations between aldosterone and both leptin and adiponectin were not materially changed with additional adjustment for PRA. Exclusion of those taking antihypertensive medications modestly attenuated the associations. The associations between leptin and both PRA and aldosterone were not different by gender but were significantly stronger among non-Hispanic Whites and Chinese Americans than African and Hispanic Americans (P<0.01). The findings suggest that both adiponectin and leptin may be relevant to blood pressure regulation via the RAAS, in that the associations appear to be robust to antihypertension medication use and that the associations are likely different by ethnicity.
在肥胖个体中，交感神经系统（SNS）活性增加会导致肾素和醛固酮生成增加，以及肾小管钠重吸收增加。本研究确定了脂肪因子与肾素-血管紧张素原-醛固酮系统（RAAS）的选定指标之间的关联。样本包括来自动脉粥样硬化多民族研究的1970名男性和女性，他们在基线时无临床心血管疾病，并对其血液进行了脂联素、瘦素、血浆肾素活性（PRA）和醛固酮检测。平均年龄为64.7岁，50%为女性。PRA和醛固酮的平均值（标准差）分别为1.45（0.56）ng ml⁻¹和150.1（130.5）pg ml⁻¹。经过多变量调整后，瘦素增加1个标准差与PRA升高0.55 ng ml⁻¹和醛固酮升高8.4 pg ml⁻¹相关（两者P<0.01）。尽管脂联素与PRA水平无显著关联，但该脂肪因子增加相同幅度与醛固酮水平降低相关（-5.5 pg ml⁻¹，P=0.01）。值得注意的是，在对PRA进行额外调整后，醛固酮与瘦素和脂联素之间的关联没有实质性变化。排除服用抗高血压药物的人后，这些关联略有减弱。瘦素与PRA和醛固酮之间的关联在性别上没有差异，但在非西班牙裔白人和华裔美国人中比非裔美国人和西班牙裔美国人更强（P<0.01）。研究结果表明，脂联素和瘦素可能都通过RAAS与血压调节相关，因为这些关联似乎不受抗高血压药物使用的影响，而且这些关联可能因种族而异。
