title: Hypoadiponectinemia is associated with blood pressure increase in obese insulin-resistant individuals.
abstract: Adiponectin is a major adipocytokine and has been considered as an independent risk factor for arterial hypertension. Most studies on the subject have been restricted to biracial (white-black) and Asian groups. The present report examined whether adiponectin affects blood pressure in a sample of untreated obese Brazilians of multiethnic origin. Fasting plasma adiponectin and serum insulin were determined by radioimmunoassay. Insulin resistance was estimated by homeostatic model assessment of insulin resistance (HOMA-IR). Blood pressure was recorded using Dinamap 1846 (Critikon, Tampa, FL). Adiponectin was significantly lower in obese hypertensive individuals than in obese normotensive ones. Blood pressure, insulin, and HOMA-IR were significantly higher in obese hypertensive than in obese normotensive individuals. Plasma adiponectin was negatively associated with waist-to-hip ratio, blood pressure, insulin, and HOMA-IR. The comparison of obese individuals who markedly differed in their HOMA-IR (> vs <or=2.71) showed that the association of adiponectin and blood pressure remained significant only in obese insulin-resistant individuals, whose adiponectin showed a positive association with high-density lipoprotein cholesterol. Stepwise regression analysis revealed that HOMA-IR, adiponectin, body mass index, and age independently affected the risk for increased systolic blood pressure, with HOMA-IR the strongest of them all. Finally, when patients were stratified into tertiles of HOMA-IR and further classified according to the 50th percentile of adiponectin (<or= vs >6. 5 microg/mL), a 3 x 2 analysis of variance showed an independent contribution of adiponectin in the variation of mean arterial pressure. These results support the notion that HOMA-IR and adiponectin independently predict blood pressure variation in obese insulin-resistant Brazilians.
authors.affiliation: Hypertension Clinic, Laboratory of Clinical and Experimental Pathophysiology, School of Medicine, Rio de Janeiro State University, RJ CEP 22221-090, Brazil. francischetti@globo.com
authors.forename: Emilio A
authors.initials: EA
authors.lastname: Francischetti
authors.forename: Bruno M J
authors.initials: BM
authors.lastname: Celoria
authors.forename: Stenio Fernando Pimentel
authors.initials: SF
authors.lastname: Duarte
authors.forename: Elizabeth Goes
authors.initials: EG
authors.lastname: da Silva
authors.forename: Isabel Jereissati
authors.initials: IJ
authors.lastname: Santos
authors.forename: Pedro H
authors.initials: PH
authors.lastname: Cabello
authors.forename: Virginia A
authors.initials: VA
authors.lastname: Genelhu
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000150:complications / Q000503:physiopathology*
chemical_list: D052242:Adiponectin