부산대학교 도서관

Background : Chronic obesity is a major risk factor for hypertension, and obesity-associated hypertension is often difficult to control. Adipokines have vascular effects, but the degree to which they mediate the association between chronic obesity and hypertension is unknown.Methods: We conducted a cross-sectional analysis of 10,842 ARIC participants who attended Visit 3 (1993-95) with self-reported BMI at age 25 and measured BMI at visits 1 to 3 (each 3 years apart). We calculated cumulative excess BMI years by centering BMI at 25 kg/m at each time point and multiplying the mean BMI by the duration in years from age 25 to Visit 3. We categorized cumulative excess BMI years by quartiles. Plasma adipokines (leptin, adiponectin) were measured at Visit 3. Prevalent hypertension at Visit 3 was defined as blood pressure ≥130/80mmHg or hypertension medication use. We used linear regression to assess associations between cumulative BMI quartiles and adipokines (log transformed). We used logistic regression to assess the association of cumulative BMI with prevalent hypertension and the extent to which adipokines mediate this relationship.Results: Higher quartiles of cumulative excess BMI years were associated with lower adiponectin and higher leptin levels (both p<0.001). Higher cumulative excess BMI years was strongly associated with hypertension (OR 2.52 [95% CI 2.21, 2.87], for top vs bottom quartile). Adiponectin partially mediated the association of cumulative excess BMI years with hypertension by 7% (OR for top quartile decreased from 2.52 to 2.41), leptin mediated the association by 18% (OR decreased from 2.52 to 2.24), and the combination of adiponectin and leptin mediated the association by 22% (OR decreased from 2.52 to 2.18) (Table).Conclusion: Adipokines may partially mediate the association of long-term excess adiposity with hypertension. Targeting adipokines may have therapeutic value in managing hypertension in those with chronic obesity.