Zachariah Justin P, Hwang Susan, Hamburg Naomi M, Benjamin Emelia J, Larson Martin G, Levy Daniel, Vita Joseph A, Sullivan Lisa M, Mitchell Gary F, Vasan Ramachandran S
From the Department of Cardiology, Boston Children's Hospital and Department of Pediatrics Harvard Medical School, MA (J.P.Z.); Department of Biostatistics (S.H., L.M.S.) and Department of Epidemiology (E.J.B., R.S.V.), Boston University School of Public Health, MA; Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, MA (N.M.H., E.J.B., J.A.V., R.S.V.); Boston University's and National Heart, Blood and Lung Institute's Framingham Heart Study, Framingham, MA (E.J.B., M.G.L., D.L., J.A.V., R.S.V.); Department of Mathematics, Boston University, MA (M.G.L.); and Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.).
Hypertension. 2016 Feb;67(2):294-300. doi: 10.1161/HYPERTENSIONAHA.115.05949. Epub 2015 Nov 30.
Adipokines may be potential mediators of the association between excess adiposity and vascular dysfunction. We assessed the cross-sectional associations of circulating adipokines with vascular stiffness in a community-based cohort of younger adults. We related circulating concentrations of leptin and leptin receptor, adiponectin, retinol-binding protein 4, and fatty acid-binding protein 4 to vascular stiffness measured by arterial tonometry in 3505 Framingham Third Generation cohort participants free of cardiovascular disease (mean age 40 years, 53% women). Separate regression models estimated the relations of each adipokine to mean arterial pressure and aortic stiffness, as carotid femoral pulse wave velocity, adjusting for age, sex, smoking, heart rate, height, antihypertensive treatment, total and high-density lipoprotein cholesterol, diabetes mellitus, alcohol consumption, estimated glomerular filtration rate, glucose, and C-reactive protein. Models evaluating aortic stiffness also were adjusted for mean arterial pressure. Mean arterial pressure was positively associated with blood retinol-binding protein 4, fatty acid-binding protein 4, and leptin concentrations (all P<0.001) and inversely with adiponectin (P=0.002). In fully adjusted models, mean arterial pressure was positively associated with retinol-binding protein 4 and leptin receptor levels (P<0.002 both). In fully adjusted models, aortic stiffness was positively associated with fatty acid-binding protein 4 concentrations (P=0.02), but inversely with leptin and leptin receptor levels (P≤0.03 both). In our large community-based sample, circulating concentrations of select adipokines were associated with vascular stiffness measures, consistent with the hypothesis that adipokines may influence vascular function and may contribute to the relation between obesity and hypertension.
脂肪因子可能是肥胖与血管功能障碍之间关联的潜在介质。我们在一个以社区为基础的年轻成年人队列中评估了循环脂肪因子与血管僵硬度之间的横断面关联。我们将瘦素及其受体、脂联素、视黄醇结合蛋白4和脂肪酸结合蛋白4的循环浓度与通过动脉张力测定法测量3505名无心血管疾病的弗雷明汉第三代队列参与者（平均年龄40岁，53%为女性）的血管僵硬度相关联。单独的回归模型估计了每种脂肪因子与平均动脉压和主动脉僵硬度（如颈动脉-股动脉脉搏波速度）之间的关系，并对年龄、性别、吸烟、心率、身高、降压治疗、总胆固醇和高密度脂蛋白胆固醇、糖尿病、饮酒、估计肾小球滤过率、血糖和C反应蛋白进行了校正。评估主动脉僵硬度的模型也对平均动脉压进行了校正。平均动脉压与血液视黄醇结合蛋白4、脂肪酸结合蛋白4和瘦素浓度呈正相关（均P<0.001），与脂联素呈负相关（P=0.002）。在完全校正的模型中，平均动脉压与视黄醇结合蛋白4和瘦素受体水平呈正相关（均P<0.002）。在完全校正的模型中，主动脉僵硬度与脂肪酸结合蛋白4浓度呈正相关（P=0.02），但与瘦素和瘦素受体水平呈负相关（均P≤0.03）。在我们基于社区的大样本中，特定脂肪因子的循环浓度与血管僵硬度指标相关，这与脂肪因子可能影响血管功能并可能导致肥胖与高血压之间关系的假设一致。
