脂联素与心脏结构之间的纵向关联因高血压状态而异:年轻人冠状动脉风险发展

Shishir Sharma, Laura A Colangelo, Donald Lloyd-Jones, David R Jacobs, Myron D Gross, Samuel S Gidding, Philip Greenland
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摘要

目的:研究高血压患者10年后脂联素与心脏结构和功能的纵向关系。方法:从1985-1986年开始,对18-30岁的黑人和白人男性和女性进行多中心纵向研究。在第15年(2000-2001年)测量脂联素。超声心动图于第25年(2010-2011年)完成。参与者根据高血压的存在进行分层。通过脂联素五分位数比较危险因素调整的超声心动图变量。对危险因素调整的超声心动图变量也建立了线性和二次回归模型。结果:相对于脂联素最低的五分位数,来自最高五分位数的参与者在正常血压组中左室质量指数(LVMi)低6%,在高血压组中LVMi高8%。在正常血压的受试者中,回归分析显示脂联素与左室质量、左室心肌梗死(LVMi)、后壁厚度(PWT)和室间隔厚度(VST)呈线性负相关(均p≤0.05)。在高血压患者中,回归分析显示脂联素与左室质量、LVMi、PWT和VST呈u型关系(所有二次项p≤0.005)。结论:在血压正常的参与者中,较高的脂联素可能是未来不良心脏结构较少的有用标志。脂联素受体激动剂是否对这些个体有益还需要进一步的研究。在高血压参与者中,需要进一步的研究来评估脂联素的预后和治疗应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Longitudinal associations between adiponectin and cardiac structure differ by hypertensive status: Coronary Artery Risk Development in Young Adults.

Objective: We studied the longitudinal association between adiponectin and cardiac structure and function 10 years later stratified by hypertension status.

Methods: Multicenter longitudinal study of black and white men and women that began in 1985-1986, when participants were 18-30 years old. Adiponectin was measured at year 15(2000-2001). Echocardiograms were completed at year 25(2010-2011). Participants were stratified by the presence of hypertension. Risk factor-adjusted echocardiographic variables were compared across adiponectin quintiles. Linear and quadratic regression models were also derived for risk factor-adjusted echocardiographic variables.

Results: Relative to the lowest quintile of adiponectin, participants from the highest quintile had a 6% lower LV mass index (LVMi) among normotensives, and an 8% higher LVMi among hypertensives. Among normotensive participants, regression analysis demonstrated a linear inverse relationship between adiponectin and LV mass, LVMi, posterior wall thickness (PWT) and ventricular septal thickness (VST) (all p≤0.05). Among hypertensive participants, regression analysis demonstrated a U-shaped relationship between adiponectin and LV mass, LVMi, PWT and VST (p≤0.005 for all quadratic terms).

Conclusions: Among normotensive participants, higher adiponectin may be a useful marker of less adverse future cardiac structure. Further study is required to see if adiponectin receptor agonists may provide a benefit among these individuals. Among hypertensive participants, further study is required to assess the prognostic and therapeutic use of adiponectin.

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