633 Hypertens Res Vol.31 (2008) No.4 p.633-640
Original Article
Adiponectin, but Not Leptin or High-Sensitivity C-Reactive Protein, Is Associated with Blood Pressure Independently of General and Abdominal Adiposity Shih-Hsien SUNG1), Shao-Yuan CHUANG2), Wayne Huey-Herng SHEU3), Wen-Jane LEE4), Pesus CHOU5),6), and Chen-Huan CHEN1),5),7),8) The role of adiponectin, a marker of the metabolic syndrome, on the pathogenesis of hypertension in comparison with markers of adipose tissue mass (leptin) and inflammation (high-sensitivity C-reactive protein [hs-CRP]) remains to be clarified. The eligible study population consisted of 2,045 residents aged≥40 years who had participated in a community-based survey and had complete data for serum adiponectin, leptin, and hs-CRP, and for whom homeostasis model assessment of insulin resistance (HOMA-IR) had been calculated from insulin and plasma glucose. Among all eligible participants, as well as in the subgroup of nondiabetic normotensives (blood pressure < 140/90 mmHg and without antihypertensive medication), all three markers were significantly correlated with systolic blood pressure (negative correlation for adiponectin and positive correlations for leptin and hs-CRP). Among all participants, systolic blood pressure and the presence of hypertension were determined mainly by age, sex, body mass index, and waist circumference. None of the markers further contributed to the multivariate linear regression or logistic regression models. In contrast, adiponectin, but not leptin, hs-CRP, or HOMA-IR, was significantly associated with systolic blood pressure and the presence of pre-hypertension (blood pressure within 120–139/80–89 mmHg) after adjustment for age, sex, body mass index, and waist circumference in the nondiabetic normotensive subgroup. Similarly, adiponectin was independently associated with diastolic blood pressure in the nondiabetic normotensive subgroup but not in the whole population. In conclusion, adiponectin, but not leptin or hs-CRP, was independently associated with blood pressure in a nondiabetic normotensive subgroup. (Hypertens Res 2008; 31: 633–640) Key Words: hypertension, metabolic syndrome, inflammation, obesity
Introduction Hypertension is a major contributor to the current global dis-
ease burden, and the majority of diagnosed hypertensives are inadequately controlled (1). This lack of control may be due in part to the incomplete understanding of the pathogenesis of hypertension. Hypertension has long been defined by blood
From the 1)Department of Internal Medicine and 7)Department of Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; 2) Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan, ROC; 3)Department of Internal Medicine and 4)Department of Research and Education, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; and 5)Department of Public Health, 6)Community Medicine Research Center, and 8) Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, ROC. This work was supported in part by serial grants from the National Science Council (NSC 92-2320-B-010-058; NSC 93-2314-B-010-040; NSC 94-2314B-010-058), by intramural grants from the Taipei Veterans General Hospital (Grant No.93-198C), and grants-in-aid from the Research Foundation of Cardiovascular Medicine (91-02-032, 93-02-014), Taipei, Taiwan, ROC. Address for Reprints: Chen-Huan Chen, M.D., Department of Research and Education, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan, ROC. E-mail:
[email protected] Received August 7, 2007; Accepted in revised form October 21, 2007.
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Table 1. Characteristics of All Eligible Participants (n=2,045) and the Non-Diabetic Normotensive Subgroup (n=1,512) All eligible participants Variables Age, years Men, % BMI, kg/m2 WC, cm SBP, mmHg DBP, mmHg Fasting plasma glucose, mg/dL Fasting insulin, μU/mL HOMA-IR Adiponectin, μg/mL Leptin, ng/mL hs-CRP, mg/dL
Without hypertension (n=1,596) 55.3±10.4 31.6 23.8±3.3 84.3±9.6 119.3±10.6 75.5±7.7 101.0±21.7 13.0±6.9 3.3±2.4 10.0±5.0 6.9±5.4 0.18±0.36
With hypertension (n=449)
Non-diabetic normotensive subgroup Without preWith pre-hypertension hypertension (n=645) (n=867)
59.5±11.0** 43.2** 25.0±3.5** 89.3±10.3** 146±12** 90±9** 104.8±27.6* 14.5±7.7**,† 3.9±2.8** 10.3±5.7 7.1±5.5**,† 0.22±0.42**,†
53.2±9.5 25.1 23.1±3.14 82.0±9.4 110±7 70±6 96.3±13.0 11.6±4.8 2.8±1.2 10.7±5.0 6.74±4.77 0.15±0.32
56.5±10.7** 34.8* 24.2±3.2** 85.4±9.4** 126±7** 80±6** 98.7±16.1* 13.3±6.1**,† 3.3±1.7** 9.7±5.1**,† 7.00±5.67**,† 0.19±0.36**,†
*p DBP≥ 80 mmHg were defined as having pre-hypertension (1). We used the homeostasis model assessment of insulin resistance (HOMA-IR) to estimate the levels of insulin resistance by the equation: HOMA-IR= fasting insulin (μU/mL) × fasting glucose (mmol/L)/22.5 (3).
Statistical Methods Student’s t-test or the χ 2 test was used to compare the differences of means or percentages between groups. Pearson cor-
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Table 2. Age- and Sex-Adjusted Correlation Coefficients of Adiponectin, Leptin, and hs-CRP with Other Risk Variables Correlation coefficients, r Variables
All eligible participants log adiponectin
2
BMI, kg/m WC, cm SBP, mmHg DBP, mmHg Fasting plasma glucose, mg/dL log insulin, μU/mL HOMA-IR log adiponectin, μg/mL log leptin, ng/mL log hs-CRP, mg/dL
−0.26** −0.24** −0.08** −0.11** −0.10** −0.28** −0.22** 1.00 −0.20** −0.18**
Non-diabetic normotensive subgroup
log leptin
log hs-CRP
0.59** 0.47** 0.12** 0.16** 0.12** 0.45** 0.34** −0.20** 1.00 0.28**
0.27** 0.22** 0.05* 0.07* 0.078 0.14** 0.15** −0.18** 0.28** 1.00
log adiponectin −0.28** −0.28** −0.13** −0.16** −0.11** −0.27** −0.26** 1.00 −0.23** −0.18**
log leptin
log hs-CRP
0.58** 0.46** 0.08* 0.11** 0.14** 0.44** 0.44** −0.23** 1.00 0.25**
0.25** 0.21** 0.06* 0.05* 0.004 0.06* 0.07* −0.18** 0.25** 1.00
*p
