Majerczyk Marcin, Choręza Piotr, Bożentowicz-Wikarek Maria, Brzozowska Aniceta, Arabzada Habibullah, Owczarek Aleksander, Mossakowska Małgorzata, Grodzicki Tomasz, Zdrojewski Tomasz, Więcek Andrzej, Olszanecka-Glinianowicz Magdalena, Chudek Jerzy
Pathophysiology Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland; Department of Cardiology, District Hospital in Zakopane, Poland.
Division of Statistics, Department of Instrumental Analysis, Faculty of Pharmacy and Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Poland.
J Am Soc Hypertens. 2017 Feb;11(2):71-80. doi: 10.1016/j.jash.2016.11.009. Epub 2016 Dec 7.
Increased plasma retinol-binding protein 4 (RBP4), a novel adipokine, has been associated in previous studies with obesity, type 2 diabetes, dyslipidemia, hypertension (HT), atherosclerosis, and coronary artery disease. This study aimed to analyze the relationship between HT occurrence and its treatment, and plasma RBP4 concentrations in the older polish population. The study sample consisted of 1728 (890 men and 838 women) PolSenior study participants aged 65 years and older with available plasma samples and NT-proBNP values below 2000 pg/mL. The analysis included body mass index, waist circumference, blood pressure, antihypertensive medication, estimated glomerular filtration rate, serum glucose and insulin (and the homeostatic model assessment of insulin resistance), and plasma RBP4 levels. RBP4 plasma concentrations were higher in hypertensive (N = 645) than normotensive (N = 236) men (43.4 [30.4-64.8] vs. 38.1 [27.1-54.4] ng/mL, respectively; P < .01) but not in women (44.6 [29.6-63.5] vs. 40.7 [29.1-58.1] ng/mL, respectively; P = .21). In the subanalysis, higher plasma RBP4 levels were observed in women with treated than untreated HT and in subjects taking four of more antihypertensive drugs. The linear regression shown that estimated glomerular filtration rate (β = -0.015), thiazide diuretics (β = 0.041), and α-blockers (β = 0.049) were explaining logRBP4 plasma levels variability in the study group. Older male Caucasians with HT are characterized by elevated plasma RBP4 levels. This increase is proportional to the number of antihypertensive drugs and decreased glomerular filtration rate. Among the antihypertensive drugs, only thiazide diuretics and α-blockers had a significant influence on RBP4 levels.
血浆视黄醇结合蛋白4(RBP4)作为一种新型脂肪因子,其水平升高在以往研究中与肥胖、2型糖尿病、血脂异常、高血压(HT)、动脉粥样硬化及冠状动脉疾病相关。本研究旨在分析老年波兰人群中HT的发生及其治疗与血浆RBP4浓度之间的关系。研究样本包括1728名(890名男性和838名女性)年龄在65岁及以上的PolSenior研究参与者,他们有可用的血浆样本且NT - proBNP值低于2000 pg/mL。分析内容包括体重指数、腰围、血压、抗高血压药物、估算肾小球滤过率、血清葡萄糖和胰岛素(以及胰岛素抵抗的稳态模型评估),还有血浆RBP4水平。高血压男性(N = 645)的RBP4血浆浓度高于血压正常男性(N = 236)(分别为43.4 [30.4 - 64.8] ng/mL和38.1 [27.1 - 54.4] ng/mL;P <.01),但女性中并非如此(分别为44.6 [29.6 - 63.5] ng/mL和40.7 [29.1 - 58.1] ng/mL;P =.21)。在亚分析中,接受治疗的女性HT患者比未治疗的女性HT患者以及服用四种及以上抗高血压药物的受试者血浆RBP4水平更高。线性回归显示,估算肾小球滤过率(β = -0.015)、噻嗪类利尿剂(β = 0.041)和α受体阻滞剂(β = 0.049)可解释研究组中logRBP4血浆水平的变异性。患有HT的老年男性白种人的特征是血浆RBP4水平升高。这种升高与抗高血压药物的数量成正比,与肾小球滤过率降低有关。在抗高血压药物中,只有噻嗪类利尿剂和α受体阻滞剂对RBP4水平有显著影响。