Singal Aneesh M, Howard Virginia J, Judd Suzanne E, Carson April P, Zakai Neil A, Olson Nels C, Cushman Mary, Plante Timothy B
Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts.
University of Alabama at Birmingham, Birmingham, Alabama.
J Hypertens. 2025 Aug 1;43(8):1391-1399. doi: 10.1097/HJH.0000000000004057. Epub 2025 May 13.
Hypertension is a cardiovascular disease risk factor disproportionately affecting Black adults. Adiponectin is a cytokine secreted by adipocytes that improves insulin sensitivity, maintains vascular homeostasis, and is inversely associated with adiposity. We sought to determine the risk of incident hypertension by level of adiponectin.
The REasons for Geographic And Racial Differences in Stroke (REGARDS) study recruited 30 239 adults from 2003 to 2007. We included REGARDS participants in the Biomarkers as Mediators of Racial Disparities in Risk Factors (BioMedioR) substudy. We estimated the risk ratio for incident hypertension in unadjusted and adjusted models for demographics factors, dietary patterns, measures of adiposity, and SBP.
Inverse odds ratio weighting estimated the excess hypertension incidence among Black participants that was explained by adiponectin. Of the 1498 BioMedioR participants, 35% developed incident hypertension in follow-up. White adults had higher baseline adiponectin levels than Black adults. For each 1-SD higher log adiponectin, the risk ratio of hypertension was 0.90 [95% confidence interval (95% CI) 0.84-0.96] in an unadjusted model, 0.92 (0.86-1.00) in a demographic adjusted model, and 0.99 (0.91-1.07) in a fully adjusted model. Lower adiponectin mediated 21-46% of the excess risk of incident hypertension among Black relative to White participants in models adjusting for just demographics and dietary patterns.
Among Black and White adults, lower adiponectin was associated with a greater risk of incident hypertension in unadjusted and minimally adjusted models. Future studies into how adiponectin changes in obesity could help to further explain its impact on hypertension risk.
高血压是一种心血管疾病风险因素，对黑人成年人的影响尤为严重。脂联素是一种由脂肪细胞分泌的细胞因子，可改善胰岛素敏感性、维持血管稳态，且与肥胖呈负相关。我们试图通过脂联素水平来确定发生高血压的风险。
“中风地理和种族差异原因”（REGARDS）研究在2003年至2007年招募了30239名成年人。我们将REGARDS参与者纳入了“生物标志物作为风险因素种族差异的中介”（BioMedioR）子研究。我们在未调整和调整模型中估计了发生高血压的风险比，调整因素包括人口统计学因素、饮食模式、肥胖指标和收缩压。
逆概率加权法估计了脂联素可解释的黑人参与者中高血压的额外发病率。在1498名BioMedioR参与者中，35%在随访中发生了高血压。白人成年人的基线脂联素水平高于黑人成年人。在未调整模型中，每升高1个标准差的对数脂联素，高血压的风险比为0.90[95%置信区间（95%CI）0.84 - 0.96]，在人口统计学调整模型中为0.92（0.86 - 1.00），在完全调整模型中为0.99（0.91 - 1.07）。在仅针对人口统计学和饮食模式进行调整的模型中，较低的脂联素介导了黑人相对于白人参与者发生高血压额外风险的21% - 46%。
在未调整和轻度调整模型中，黑人与白人成年人中，较低的脂联素与发生高血压的风险较高相关。未来关于肥胖时脂联素如何变化的研究可能有助于进一步解释其对高血压风险的影响。
