Plasma Levels of High Molecular Weight Adiponectin are Associated with Cardiometabolic Risks in Patients with Hypertension

고혈압 환자에서 혈장 고분자량 아디포넥틴 농도와 심장-대사위험인자와의 관련성 연구

  • Chung, Hye-Kyung (Department of Nutrition Services, Youngdong Severance Hospital, Yonsei University College of Medicine) ;
  • Shin, Min-Jeong (Department of Food and Nutrition, Yeungnam University)
  • 정혜경 (연세대학교 의과대학 영동세브란스병원 영양팀) ;
  • 신민정 (영남대학교 식품영양학과)
  • Published : 2008.12.31


In the present study, we comprehensively examined the associations of plasma levels of total adiponectin and high molecular weight (HMW) adiponectin with the features of cardiometabolic risks including body fat distribution, dyslipidemia, insulin resistance and inflammatory markers in a cross-sectional study of 110 treated hypertensive patients. Blood lipid profiles, high sensitivity C-reactive protein (hsCRP) and homeostasis model assessment of insulin resistance (HOMA- IR) derived from fasting glucose and insulin concentrations were determined. Plasma levels of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), interleukin-6 (IL-6) and intercellular adhesion molecule-1 (ICAM-1) were analyzed using ELISA. The results showed that plasma levels of HMW-adiponectin were negatively associated with body mass index (BMI, r = - 0.203, p < 0.05) and waist circumference (r = -0.307, p < 0.01), which was not shown in total adiponectin. Plasma levels of HMW-adiponectin were negatively associated with triglyceride (r = -0.223, p < 0.05) and positively associated with HDL-cholesterol (r = 0.228, p < 0.05). Plasma levels of adiponectin were positively associated with HDL-cholesterol (r = 0.224, p < 0.05). Plasma levels of HMW-adiponectin were negatively associated with hsCRP (r = -0.276, p < 0.01) and IL-6 (r = -0.272, p < 0.01). In addition, there were weak associations between plasma levels of HMWadiponectin and TNF-${\alpha}$ (r = -0.163, p = 0.07) and ICAM-1 (r = -0.158, p = 0.09). However, there were no significant associations of total adiponectin with inflammatory markers except hsCRP (r = -0.203, p < 0.05). Stepwise multiple linear regression analysis showed that only plasma levels of HMW-adiponectin was an independent factor influencing serum levels of hsCRP, a marker of systemic low grade inflammation, after adjusting for age, gender, BMI, waist circumference, alcohol intake, smoking status, blood lipids, total adiponectin and drug use (p < 0.01). These results suggest that HMW-adiponectin, rather than total adiponectin, is likely to be closely associated with the features of cardiometabolic risks in treated hypertensive patients and might be effective biomarker for the prediction of cardiovascular disease.

고혈압 환자 110명을 대상으로 혈장 고분자량 아디포넥틴과 총 아디포넥틴 농도를 측정하고 심장-대사위험인자와의 관련성을 비교 평가한 연구 결과를 요약하면 다음과 같다. 1) 비만군과 비비만군으로 나누어 비교한 결과, 고분자량 아디포넥틴 농도는 비만군에서 유의적으로 낮았으나 총 아디포넥틴 농도는 두군간 유의적인 차이를 보이지 않았다. 2) 비만도를 나타내는 BMI 및 허리둘레의 경우 고분자량 아디포넥틴과 음의 상관관계를 보였으나 혈장 아디포넥틴과는 유의적인 상관관계를 보이지 않았다. 3) 혈액 지질 수준과의 상관성 평가시, 고분자량 아디포넥틴은 중성지방과 음의 상관관계를, 고밀도 콜레스테롤과는 양의 상관관계를 보였으며 혈장 아디포넥틴의 경우 단지고밀도 콜레스테롤과 유의적인 양의 상관관계를 보였다. 4) 인슐린 저항성 지표인 HOMA-IR의 경우 고분자량 아디포넥틴 및 혈장 아디포넥틴 모두와 음의 상관관계를 보였다. 5) 염증지표와의 상관성 분석 시, 고분자량 아디포넥틴은 C-반응성 단백질, IL-6과 강한 음의 상관 관계를 TNF-${\alpha}$, ICAM-1과 음의 경향을 보였으나 혈장 아디포넥틴은 C-반응성 단백질외에는 상관관계를 보이지 않았다. 또한 회귀분석 결과, 혈장 고분자량 아디포넥틴 농도는 C-반응성 단백질 수준을 예측하는 독립적 인자였다. 위의 결과로 보아 고분자량 아디포넥틴은 혈장 아디포넥틴보다 전반적으로 심장-대사위험인자와 더 많은 상관성을 보여주었다. 따라서 심혈관 질환 및 대사성증후군을 예측하고 반영하는 데 혈장 고분자량 아디포넥틴 수준이 총 아디포넥틴 수준보다 민감하고 정확한 지표로 활용될 수 있을 것이다.



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