Associations Between Circulating Adipokines And Hypertension Among Adolescents And Youths

Objective: The purpose of our study is to investigate the relationships between circulating adipokines and the prevalence of hypertension in Beijing adolescents and youths,and try to explore the role of adipokines in the pathogenesis of hypertension among adolescents and youths.Methods: Data from the Beijing Child and Adolescent Metabolic Syndrome Study(BCAMS),559 subjects aged 14~28 years(mean=20.2 years)were included.Height,weight,waist circumference(WC),FAT%,and systolic and diastolic blood pressure(SBP and DBP)were measured by trained field workers.Venous blood samples were collected after an overnight(≥12h)fasting.The concentrations of plasma glucose,total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG)were assayed.An OGTT using 75 g glucose load was performed and Hb A1 c was measured.Fibroblast Growth Factor 21(FGF21),leptin,adiponectin and retinol-binding protein-4(RBP4)were measured by ELISA(R&D Systems).Results:(1)A total of 559 adolescents and youths were included in the current study.For the total subjects,53(9.48%)of them were hypertension,including 45 boys(15.3%)and 8 girls(3%).The prevalence of hypertension in males was higher than in females,and the difference was statistically significant(P<0.001).(2)The age,height,weight,BMI,WC,FAT%,fasting blood glucose,HOMA-IR,Hb A1 C,fasting insulin,TC,TG,LDL-C,FGF21,RBP4,C-reactive protein(hs-CRP)and leptin were higher in hypertension group than those in normal blood pressure group.However,HDL-C and adiponectin were significantly lower in hypertension group than in the normal blood pressure group.(3)After adjusted for age and sex,leptin was positively correlated with SBP(r=0.438,P<0.05)and DBP(r=0.353,P <0.001).The correlation between leptin and SBP and DBP was completely attenuated(r=0.087,P=0.042 vs.r=0.017,P=0.692)after further added daily average staple food,exercise and BMI to the model.(4)After adjusted for age and sex,adiponectin was negatively correlated with SBP(r =-0.23,P<0.001)and DBP(r=-0.208,P<0.001).When daily average staple food,exercise and BMI were simultaneously entered in the model,there was no significant correlation between adiponectin and SBP and DBP.(5)After adjusted for age and sex,RBP4 was positively correlated with SBP(r=0.137,P=0.001),and DBP(correlation was not significant;r = 0.08,P = 0.06).When daily average staple food,exercise and BMI were simultaneously entered in the model,there was no significant correlation between RBP4 and SBP and DBP.(6)After adjusted for age and sex,FGF21 was positively correlated with SBP(r = 0.275,P <0.001)and DBP(r = 0.277,P <0.001).Further adjusted for daily average staple food,exercise and BMI,the correlations between FGF21 and SBP and DBP were still significant(r = 0.15,P = 0.001 vs.r = 0.167,P <0.001).(7)SBP increased 1.54 mm Hg and DBP increased 1.55 mm Hg for 1 SD higher Lg FGF21.(8)There was a positive relationship between circulating FGF21 and the risk of hypertension after individually adjusting for potential confounders,such as age,sex,BMI,WC,and FAT%.The association remained unchanged in models that added lifestyle variables,including the average daily amount of staple food,smoking,alcohol intake,and moderately active,to the baseline model(OR=2.07,95% CI 1.32-3.27).When other metabolic disorders,including TC,TG,LDL-C,HDL-C,HOMA-IR,fasting blood-glucose,Hb A1 C,fasting insulin,and hs-CRP,were simultaneously added to the model 3,the association between FGF21 and hypertension was also statistically significant(OR=1.83;95% CI 1.08-3.09).Likewise,when leptin,adiponectin,and RBP4 were simultaneously entered in the model 4,Lg FGF21 was still a significant risk factor for hypertension,with an odds ratio(95% confidence interval)of 1.84(1.07-3.12)for 1 SD higher Lg FGF21(P =0.028).Conclusion: Leptin,adiponectin and RBP4 are linearly related to systolic and diastolic blood pressure,but these correlations may be influenced by factors such as lifestyle and adipokines interactions,and further studies are needed to confirm.In adolescents and young people,FGF21 levels are closely related to hypertension,and FGF21 is an independent risk factor for hypertension.Control of serum FGF21 levels may be important for the prevention and treatment for hypertension among adolescents and youths.In addition,it is expected to provide new therapeutic ideas and therapeutic targets for the treatment of hypertension.