血清脂联素水平低与代谢综合征相关，并且是高血压患者外周动脉僵硬度的独立标志物。
Low serum adiponectin level is associated with metabolic syndrome and is an independent marker of peripheral arterial stiffness in hypertensive patients.
作者信息
Chen Ming-Chun, Lee Chung-Jen, Yang Chiu-Fen, Chen Yu-Chih, Wang Ji-Hung, Hsu Bang-Gee
机构信息
Department of Pediatrics, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan.
出版信息
Diabetol Metab Syndr. 2017 Jun 28;9:49. doi: 10.1186/s13098-017-0247-8. eCollection 2017.
BACKGROUND
Adiponectin has been implicated in metabolic syndrome (MetS) and arterial stiffness (AS). We aim to determine the relationship between serum adiponectin concentration as well as peripheral AS in hypertensive patients.
METHODS
Fasting blood samples were obtained from 101 hypertensive patients. Brachial-ankle pulse wave velocity (baPWV) was measured with an automatic pulse wave analyzer. Serum adiponectin concentrations were determined by using an enzyme immunoassay kit. A baPWV >14.0 m/s was defined as high AS.
RESULTS
MetS and high AS were present in 62.4 and 71.3% of the study population. Adiponectin was inversely associated with MetS and high AS (both < 0.001). Serum higher high-density lipoprotein cholesterol (HDL-C) ( = 0.012), triglycerides ( = 0.001), C-reactive protein ( < 0.001), insulin ( = 0.027), body weight ( = 0.002), waist circumference (WC, < 0.001), body mass index ( = 0.001) bilateral-baPWV ( < 0.001), systolic blood pressure (SBP, < 0.001), diastolic blood pressure (DBP, = 0.012), pulse pressure ( = 0.019), homeostasis model assessment of insulin resistance (HOMA1-IR ( = 0.026) and HOMA2-IR ( = 0.020)) and lower glomerular filtration rate (GFR, = 0.029) were significantly associated with high AS. Multivariate logistic regression analysis of the factors significantly associated with AS revealed that adiponectin [odds ratio: 0.932, 95% confidence interval (CI) 0.881-0.985, = 0.012], and SBP (odds ratio: 1.059, 95% CI 1.008-1.113, = 0.022) were the independent predictors of arterial stiffness in hypertensive patients. Subgroup analysis revealed that SBP (odds ratio: 1.126, 95% CI 1.024-1.237, = 0.014) and GFR (odds ratio: 0.858, 95% CI 0.739-0.996, = 0.043) were the independent predictors of arterial stiffness in hypertensive patients without MetS; adiponectin (odds ratio: 0.909, 95% CI 0.931-0.996, = 0.040) was the independent predictor of arterial stiffness in hypertensive patients with MetS.
CONCLUSIONS
Hypoadiponectinemia has positive association with MetS and peripheral AS in hypertensive patients.
背景
脂联素与代谢综合征（MetS）和动脉僵硬度（AS）有关。我们旨在确定高血压患者血清脂联素浓度与外周动脉僵硬度之间的关系。
方法
从101例高血压患者中采集空腹血样。使用自动脉搏波分析仪测量臂踝脉搏波速度（baPWV）。采用酶免疫分析试剂盒测定血清脂联素浓度。baPWV>14.0 m/s被定义为高动脉僵硬度。
结果
研究人群中62.4%存在代谢综合征，71.3%存在高动脉僵硬度。脂联素与代谢综合征和高动脉僵硬度呈负相关（均P<0.001）。血清较高的高密度脂蛋白胆固醇（HDL-C）（P = 0.012）、甘油三酯（P = 0.001）、C反应蛋白（P<0.001）、胰岛素（P = 0.027）、体重（P = 0.002）、腰围（WC，P<0.001）、体重指数（P = 0.001）、双侧baPWV（P<0.001）、收缩压（SBP，P<0.001）、舒张压（DBP，P = 0.012）、脉压（P = 0.019）、胰岛素抵抗稳态模型评估（HOMA1-IR（P = 0.026）和HOMA2-IR（P = 0.020））以及较低的肾小球滤过率（GFR，P = 0.029）与高动脉僵硬度显著相关。对与动脉僵硬度显著相关的因素进行多变量逻辑回归分析显示，脂联素[比值比：0.932，95%置信区间（CI）0.881 - 0.985，P = 0.012]和收缩压（比值比：1.059，95%CI 1.008 - 1.113，P = 0.022）是高血压患者动脉僵硬度的独立预测因素。亚组分析显示，收缩压（比值比：1.126，95%CI 1.024 - 1.237，P = 0.014）和肾小球滤过率（比值比：0.858，95%CI 0.739 - 0.996，P = 0.043）是无代谢综合征高血压患者动脉僵硬度的独立预测因素；脂联素（比值比：0.909，95%CI 0.931 - 0.996，P = 0.040）是有代谢综合征高血压患者动脉僵硬度的独立预测因素。
结论
低脂联素血症与高血压患者的代谢综合征和外周动脉僵硬度呈正相关。
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