Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital, Lodz, Poland.
Arch Med Sci. 2012 Jul 4;8(3):431-6. doi: 10.5114/aoms.2012.29397.
Hypertension often coexists with obesity. Adipokines, ghrelin and insulin play important roles in the pathogenesis of both diseases. The aim of this study was to compare adiponectin, leptin, resistin, insulin and ghrelin mean serum concentrations and insulin resistance (HOMA-IR) in normo- and hypertensive patients with obesity.
ALL INCLUDED PATIENTS WERE DIVIDED ON THE FOLLOWING GROUPS: non-diabetic hypertensive patients with class I obesity (group A, n = 21) and class II/III obesity (group B, n = 10), and normotensive obese (class I)patients (group C, n = 7). Correlations between obesity indices (body mass index [BMI], waist-to-hip ratio [WHR], waist circumference [WC]), HOMA-IR, and hormone and adipokine serum levels were also analyzed.
Leptin level and HOMA-IR were significantly higher in group B compared to group C (9.74 ±3.88 ng/ml vs. 4.53 ±3.00 ng/ml; p < 0.02 and 3.30 ±1.59 vs. 1.65 ±0.41; p < 0.02, respectively). A negative correlation between WC and adiponectin level (R = -0.6275; p < 0.01) and a positive correlation between WC and insulin concentration (R = 0.5122; p< 0.05) as well as with HOMA-IR (R = 0.5228; p < 0.02) were found in group A. Negative correlations between BMI and ghrelin level (R = -0.7052; p < 0.05), WHR and adiponectin level (R = -0.6912; p < 0.05) and WHR and leptin level (R = -0.6728; p < 0.05) were observed in group B.
Insulin resistance and leptin may be important pathogenic factors in hypertensive patients with severe obesity. Indices of abdominal obesity (WC, WHR) correlate better than BMI with HOMA-IR, insulin, adiponectin and leptin serum levels in hypertensive obese patients.
高血压常与肥胖并存。脂肪因子、ghrelin 和胰岛素在这两种疾病的发病机制中发挥着重要作用。本研究的目的是比较正常血压和高血压肥胖患者的脂联素、瘦素、抵抗素、胰岛素和 ghrelin 血清浓度和胰岛素抵抗(HOMA-IR)。
所有纳入的患者分为以下几组:I 级肥胖的非糖尿病高血压患者(A 组,n = 21)和 II/III 级肥胖的高血压患者(B 组,n = 10)和正常血压肥胖患者(I 级)(C 组,n = 7)。还分析了肥胖指数(体重指数 [BMI]、腰臀比 [WHR]、腰围 [WC])、HOMA-IR 与激素和脂肪因子血清水平之间的相关性。
与 C 组相比,B 组的 leptin 水平和 HOMA-IR 显著升高(9.74 ±3.88ng/ml 比 4.53 ±3.00ng/ml;p<0.02 和 3.30 ±1.59 比 1.65 ±0.41;p<0.02)。A 组中,WC 与脂联素水平呈负相关(R = -0.6275;p<0.01),WC 与胰岛素浓度呈正相关(R = 0.5122;p<0.05)和 HOMA-IR(R = 0.5228;p<0.02)。A 组中,BMI 与 ghrelin 水平呈负相关(R = -0.7052;p<0.05),WHR 与脂联素水平呈负相关(R = -0.6912;p<0.05)和 WHR 与瘦素水平呈负相关(R = -0.6728;p<0.05)。
胰岛素抵抗和瘦素可能是严重肥胖高血压患者的重要致病因素。与 BMI 相比,腹部肥胖指数(WC、WHR)与高血压肥胖患者的 HOMA-IR、胰岛素、脂联素和瘦素血清水平相关性更好。