Metabolism, Nutrition, and Atherosclerosis Laboratory, Department of Clinical and Experimental Medicine (M.C., D.T., S.L., A.N.), University of Pisa, Italy.
Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine (D.T.), University of Pisa, Italy.
Hypertension. 2022 Jan;79(1):36-46. doi: 10.1161/HYPERTENSIONAHA.121.18048. Epub 2021 Oct 25.
The pathophysiological link between adiposity and blood pressure is not completely understood, and evidence suggests an influence of sex and genetic determinants. We aimed to identify the relationship between adiposity and blood pressure, independent of a robust set of lifestyle and metabolic factors, and to examine the modulating role of sex and Angiotensin-Converting Enzyme (ACE) insertion/deletion (I/D) polymorphisms. In the Relationship Between Insulin Sensitivity and Cardiovascular Disease (RISC) study cohort, 1211 normotensive individuals, aged 30 to 60 years and followed-up after 3.3 years, were characterized for lifestyle and metabolic factors, body composition, and genotype. Body mass index (BMI) and waist circumference (WC) were independently associated with mean arterial pressure, with a stronger relationship in women than men (BMI: =0.40 versus 0.30; WC: =0.40 versus 0.30, both <0.01) and in individuals with the and genotypes in both sexes (<0.01). The associations of BMI and WC with mean arterial pressure were independent of age, sex, lifestyle, and metabolic variables (standardized regression coefficient=0.17 and 0.18 for BMI and WC, respectively) and showed a significant interaction with the genotype only in women (=0.03). A 5 cm larger WC at baseline increased the risk of developing hypertension at follow-up only in women (odds ratio, 1.56 [95% CI, 1.15-2.10], =0.004) and in genotype carriers (odds ratio, 1.87 [95% CI, 1.09-3.20], =0.023). The hypertensive effect of adiposity is more pronounced in women and in people carrying the variant of the genotype, a marker of salt sensitivity.
肥胖与血压之间的病理生理联系尚不完全清楚，有证据表明性别和遗传因素有影响。我们的目的是确定肥胖与血压之间的关系，这种关系独立于一系列强大的生活方式和代谢因素，并研究性别和血管紧张素转换酶（ACE）插入/缺失（I/D）多态性的调节作用。在胰岛素敏感性与心血管疾病的关系（RISC）研究队列中，我们对 1211 名年龄在 30 至 60 岁之间的血压正常的个体进行了生活方式和代谢因素、身体成分和基因型的特征描述。随访 3.3 年后，体重指数（BMI）和腰围（WC）与平均动脉压独立相关，女性的相关性强于男性（BMI：=0.40 比 0.30；WC：=0.40 比 0.30，均 <0.01），且在两性中携带和基因型的个体中也存在更强的相关性（<0.01）。BMI 和 WC 与平均动脉压的相关性独立于年龄、性别、生活方式和代谢变量（BMI 和 WC 的标准化回归系数分别为 0.17 和 0.18），且仅在女性中与基因型存在显著交互作用（=0.03）。基线时 WC 增加 5cm，仅在女性（比值比，1.56[95%可信区间，1.15-2.10]，=0.004）和携带基因型的个体中，发生高血压的风险增加（比值比，1.87[95%可信区间，1.09-3.20]，=0.023）。肥胖对血压的影响在女性和携带基因型的个体中更为明显，该基因型是盐敏感性的标志物。
