Creber Chloe, Cooper Richard S, Plange-Rhule Jacob, Bovet Pascal, Lambert Estelle V, Forrester Terrence E, Schoeller Dale, Riesen Walter, Korte Wolfgang, Cao Guichan, Luke Amy, Dugas Lara R
Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA.
Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
BMC Cardiovasc Disord. 2018 Jan 10;18(1):4. doi: 10.1186/s12872-017-0737-5.
Obesity is a major risk factor for hypertension, however, the physiologic mechanisms linking increased adiposity to elevations in blood pressure are not well described. An increase in resting energy expenditure (REE) is an obligatory consequence of obesity. Previous survey research has demonstrated that REE is an independent predictor of blood pressure, and eliminates the co-linear association of body mass index. This observation has received little attention and there have been no attempts to provide a causal explanation.
At baseline in an international comparative study on obesity, 289 participants aged 25-44 were recruited from communities in the US, the Seychelles, Ghana and South Africa and had REE measured with indirect calorimetry. All participants were thought to be free of major illness.
In multivariate regression models, both systolic and diastolic blood pressure were positively associated with REE (p < 0.01), while body mass index and fat mass were negatively correlated with systolic blood pressure (p < 0.01, and p < 0.05 respectively), but not diastolic blood pressure.
These data confirm previous reports and suggest that a common physiologic abnormality links REE and blood pressure. Elevated catecholamines, a putative metabolic characteristic of obesity, is a possible candidate to explain this association. The direct role of excess adipose tissue is open to question.
肥胖是高血压的主要危险因素，然而，将肥胖增加与血压升高联系起来的生理机制尚未得到充分描述。静息能量消耗（REE）增加是肥胖必然产生的结果。先前的调查研究表明，REE是血压的独立预测因子，并且消除了体重指数的共线性关联。这一观察结果很少受到关注，也没有人试图给出因果解释。
在一项关于肥胖的国际比较研究的基线阶段，从美国、塞舌尔、加纳和南非的社区招募了289名年龄在25 - 44岁之间的参与者，并用间接测热法测量了他们的REE。所有参与者被认为没有重大疾病。
在多变量回归模型中，收缩压和舒张压均与REE呈正相关（p < 0.01），而体重指数和脂肪量与收缩压呈负相关（分别为p < 0.01和p < 0.05），但与舒张压无关。
这些数据证实了先前的报道，并表明一种常见的生理异常将REE与血压联系起来。儿茶酚胺升高是肥胖的一种假定代谢特征，可能是解释这种关联的一个候选因素。过多脂肪组织的直接作用尚有待探讨。
