title: Adiponectin levels and the risk of hypertension: a systematic review and meta-analysis.
abstract: Animal studies and small controlled studies in humans suggest that adiponectin may regulate blood pressure via brain-mediated and endothelium-mediated mechanisms. We performed a systematic review and meta-analysis to evaluate the epidemiological evidence on plasma adiponectin levels and hypertension in free-living adult population. A systematic search of MEDLINE and EMBASE, up to February 2013, identified 43 nonprospective and 5 prospective studies that included 17 598 adults (8220 with hypertension; mean age 19-69 years; and mean body mass index 22-38 kg/m(2)). Two investigators independently extracted data on adiponectin levels by hypertension status and dose-response relationship. We used a random-effects model to compute the weighted mean difference in adiponectin levels between adults with hypertension and normotensive adults and a 2-stage generalized least-square trend methods to compute the odds ratio of hypertension per 1 µg/mL increase in adiponectin. Adults with hypertension had 1.64 µg/mL (95% confidence interval, -2.07, -1.21) lower adiponectin levels than normotensive adults. Every 1 µg/mL increase in adiponectin levels was associated with 6% reduced risk of hypertension (95% confidence interval, 0.92, 0.97). These findings were consistent across study design and characteristics, including age, sex, and body mass index (P>0.05). However, our meta-analysis was limited by unexplained large between-study heterogeneity, a small number of prospective studies, and selective reporting of dose-response data. In conclusion, epidemiological evidence suggests that plasma adiponectin level is a biomarker and possible mediator in the development of adiposity-related hypertension. The question remains as to adiponectin as a potential therapeutic target and its relationship with other adipokines in blood pressure regulation.
authors.affiliation: Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, USA. dkim2@bidmc.harvard.edu
authors.forename: Dae Hyun
authors.initials: DH
authors.lastname: Kim
authors.forename: Chul
authors.initials: C
authors.lastname: Kim
authors.forename: Eric L
authors.initials: EL
authors.lastname: Ding
authors.forename: Mary K
authors.initials: MK
authors.lastname: Townsend
authors.forename: Lewis A
authors.initials: LA
authors.lastname: Lipsitz
mesh_terms: D052242:Adiponectin / Q000097:blood*; D001794:Blood Pressure / Q000502:physiology*; D014943:Global Health; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D009017:Morbidity; D012307:Risk Factors
chemical_list: D052242:Adiponectin
keywords: adiponectin; blood pressure; hypertension; obesity; review, systematic