Olszanecka Agnieszka, Dragan Aneta, Kawecka-Jaszcz Kalina, Fedak Danuta, Czarnecka Danuta
1st Department of Cardiology, Interventional Electrocardiology, and Hypertension, Jagiellonian University Medical College, Krakow, Poland.
1st Department of Cardiology, Interventional Electrocardiology, and Hypertension, Jagiellonian University Medical College, Krakow, Poland.
Metabolism. 2017 Apr;69:96-106. doi: 10.1016/j.metabol.2017.01.005. Epub 2017 Jan 12.
During the transition from premenopause to postmenopause, many women experience weight gain and central fat deposition; therefore, we hypothesized that circulating growth factors can play a role in the pathogenesis of hypertension, metabolic syndrome, and subclinical organ damage in perimenopausal women.
The study included 192 women aged 40 to 60years; 152 had newly diagnosed essential hypertension that had never been treated, and 40 were normotensive age-matched controls. For all subjects, 24-h ambulatory blood pressure monitoring (ABPM), echocardiographic examination with assessment of left ventricular mass (LVM) and systolic and diastolic functions (GE Vivid 7.0, General Electric Vingmed Ultrasound, Horten, Norway), carotid ultrasound with measurement of intima-media thickness, and carotid-femoral pulse wave velocity (PWV) measurement (SphygmoCor, AtCor Medical, Sydney, Australia) were performed. Serum levels of insulin-like growth factor 1 (IGF-1), insulin-like growth factor-binding protein 2 (IGFBP-2), and insulin-like growth factor-binding protein 3 (IGFBP-3) were measured using an immunochemical assay.
Hypertensive women had significantly lower IGFBP-2 levels than did normotensive controls (162.9±83.7 vs. 273.1±103.0μg/L, p<0.001); the groups did not differ regarding IGF and IGFBP-3 concentrations. After adjusting the covariates, multivariate analysis showed that IGFBP2 was significantly negatively correlated with 24-h systolic blood pressure (β=-0.31, p=0.02). The adjusted odds ratio for hypertension per standard deviation decrease in IGFBP-2 was 3.43 (95% confidence interval [CI] 1.65-7.13). IGFBP-2 showed a negative correlation with the number of metabolic syndrome components. Independent of body composition, IGFBP-2 was significantly related to left ventricular relative wall thickness and the ratio of mitral inflow velocities as parameter of diastolic function.
In perimenopausal women, decreased IGFBP-2 levels may play a role in blood pressure regulation and the development of subclinical left ventricular diastolic dysfunction. Whether IGFBP-2 is a marker or a mediator of cardiovascular disease in this population merits further investigation.
在从绝经前过渡到绝经后的过程中，许多女性会出现体重增加和中心性脂肪沉积；因此，我们推测循环生长因子可能在围绝经期女性高血压、代谢综合征和亚临床器官损伤的发病机制中起作用。
该研究纳入了192名年龄在40至60岁的女性；其中152名是新诊断出的未经治疗的原发性高血压患者，40名是年龄匹配的血压正常对照者。对所有受试者进行了24小时动态血压监测（ABPM）、评估左心室质量（LVM）以及收缩和舒张功能的超声心动图检查（GE Vivid 7.0，通用电气Vingmed超声公司，挪威霍滕）、测量内膜中层厚度的颈动脉超声检查以及测量颈动脉-股动脉脉搏波速度（PWV）（SphygmoCor，AtCor Medical公司，澳大利亚悉尼）。采用免疫化学分析法测量血清胰岛素样生长因子1（IGF-1）、胰岛素样生长因子结合蛋白2（IGFBP-2）和胰岛素样生长因子结合蛋白3（IGFBP-3）的水平。
高血压女性的IGFBP-2水平显著低于血压正常的对照者（162.9±83.7 vs. 273.1±103.0μg/L，p<0.001）；两组在IGF和IGFBP-3浓度方面无差异。在调整协变量后，多变量分析显示IGFBP2与24小时收缩压显著负相关（β=-0.31，p=0.02）。IGFBP-2每降低一个标准差，高血压的调整后比值比为3.43（95%置信区间[CI] 1.65-7.13）。IGFBP-2与代谢综合征组分的数量呈负相关。独立于身体组成，IGFBP-2与左心室相对壁厚度以及作为舒张功能参数的二尖瓣流入速度比值显著相关。
在围绝经期女性中，IGFBP-2水平降低可能在血压调节和亚临床左心室舒张功能障碍的发生中起作用。IGFBP-2在该人群中是心血管疾病的标志物还是介质，值得进一步研究。
