leptin and Essential-Hypertension

The genes encoding adipose-derived hormone leptin and its receptor (LEPR) are increasingly deemed as hypertension-susceptibility genes. In this meta-analysis, we summarized the association of the II/I polymorphism in leptin gene and Gln223Arg polymorphism in LEPR gene with hypertension and circulating leptin.. PubMed and Embase were systematically searched. Data extraction and study quality were assessed in duplicate. Statistical analyses were carried out with the STATA software (v. 11.2).. A total of 11 articles written in English were eligible. Overall analysis identified a significant association between II/I polymorphism I allele and increased risk of hypertension under allelic (odds ratio; 95% confidence interval; P: 1.48; 1.06-2.08; 0.022) and homozygous genotypic (2.27; 1.20-4.29; 0.012) models. The magnitude of the association for II/I polymorphism I allele with hypertension was substantiated in Asians and for essential hypertension under both genetic models. Overall and subgroup analyses failed to reveal any significance for the association between the Gln223Arg polymorphism and hypertension risk. Carriers of Gln223Arg polymorphism Gln/Gln genotype had significantly higher circulating leptin than the Arg/Arg genotype carriers (weighted mean difference; 95% confidence interval; P: 1.61 ng/mL; 0.02-3.20; 0.047), and this significance persisted in essential hypertension subgroup (1.69 ng/mL; 0.02-3.35; 0.047). There were low probabilities of publication bias for the above comparisons.. Our findings support the contributory role of the II/I polymorphism in leptin gene in the pathogenesis of hypertension, and this role was more evident in Asians and for essential hypertension.

Topics: Alleles; Asian People; Essential Hypertension; Gene Frequency; Genetic Predisposition to Disease; Genotype; Humans; Hypertension; Leptin; Obesity; Odds Ratio; Polymorphism, Single Nucleotide; Receptors, Leptin; White People

Adipokines are hormones produced by adipocytes and have been involved in multiple pathologic pathways, including inflammatory and cardiovascular complications in essential hypertension. Arterial stiffness is a frequent vascular complication that represents increased cardiovascular risk in hypertensive patients. Adipokines, such as adiponectin, leptin and resistin, might be implicated in hypertension, as well as in vascular alterations associated with this condition. Arterial stiffness has proven to be a predictor of cardiovascular events. Obesity and target-organ damage such as arterial stiffness are features associated with hypertension. This review aims to update the association between adipokines and arterial stiffness in essential and resistant hypertension (RHTN).

Topics: Adipocytes; Adipokines; Adiponectin; Essential Hypertension; Humans; Hypertension; Leptin; Obesity; Resistin; Risk Factors; Vascular Stiffness

Activation of the renin-angiotensin-aldosterone system (RAAS) and abnormal adipokine levels are biological alterations that affect blood pressure regulation and interact to link hypertension, obesity and metabolic diseases. While imbalanced levels of hormones produced by adipocytes including hypo-adiponectinaemia and hyperleptinaemia were reported in hypertension, little is known about how antihypertensive therapy affects these alterations. This study aimed to evaluate the effects of enalapril on plasma adiponectin and leptin levels in hypertensive individuals. Thirty-seven untreated hypertensive patients were prospectively treated with enalapril for 8 weeks. Blood samples were collected at baseline and after the treatment with enalapril. Plasma adiponectin and leptin levels were measured by enzyme-linked immunoassay. We found significant increases in adiponectin levels after enalapril treatment (5.4 ± 3.7 versus 6.0 ± 4.5 μg/mL, mean ± S.D., p = 0.04). Conversely, leptin levels were unchanged (18.0 ± 14.7 versus 18.4 ± 14.8 ng/mL, mean ± S.D., p = 0.31). Multiple linear regression revealed that baseline leptin is a significant predictor of systolic blood pressure reduction (β=0.269, p = 0.01) in hypertensive individuals treated with enalapril. While enalapril increases adiponectin levels in hypertensive individuals, baseline leptin levels predict blood pressure reduction in response to this therapy. These findings support the idea of an important relationship between RAAS and adipose tissue in hypertension and suggest that enalapril improves the adipokine profile, possibly allowing beneficial effects to overweight or obese hypertensive individuals.

Topics: Adiponectin; Adult; Angiotensin-Converting Enzyme Inhibitors; Enalapril; Essential Hypertension; Female; Humans; Hypertension; Leptin; Linear Models; Male; Middle Aged; Prospective Studies

Elevated serum leptin concentrations are closely related to sympathetic nervous system activation in essential hypertension (EH); however, it is not clear whether or not they are associated with parasympathetic nervous system impairment in EH. Heart rate recovery (HRR) is a reproducible method used to assess parasympathetic activity. This study aimed to investigate the relationship between serum leptin and HRR in Chinese untreated EH patients. This was a cross-sectional study enrolling 471 Chinese EH patients (205 men, 266 women; mean age 63.1 years). HRR was calculated during an incremental cardiopulmonary exercise test. Simple and multiple regression analyses were used to assess the correlation between serum leptin level and HRR value. Serum leptin levels elevated with increasing BP values. Moreover, univariate analysis revealed that the HRR value was negatively correlated with serum leptin (r = -0.037, P < 0.01). In multiple regression analysis, the age-adjusted serum leptin level was negatively correlated with HRR (β = -0.268, P < 0.01). Serum leptin remained negatively associated with HRR (β = -0.017, P < 0.01) after further adjustments for factors including age, systolic blood pressure, total cholesterol, and several factors that correlated with HRR. Our findings demonstrated that a raised serum leptin concentration is related to HRR blunt, which suggests that the role of leptin in the development of EH might be associated with impairment of the parasympathetic nervous system as well.

Topics: Aged; Blood Pressure; China; Cross-Sectional Studies; Essential Hypertension; Exercise Test; Female; Heart Rate; Humans; Leptin; Male; Middle Aged; Parasympathetic Nervous System

High blood pressure (BP) in children and adolescents is associated with increased risk of persistent hypertension (HT) in adulthood and, consequently, cardiovascular disease and target organ damage.. The values of selected anthropometric parameters and laboratory test results including leptin and apelin concentration were evaluated with regard to averaged values of office BP measurements and 24-hour ABPM.. The study included 55 children: 23-with primary HT and coexisting overweight or obese (HT-OB), 16-with primary HT and normal weight (HT-NW), and 16 healthy children (C).. The concentration of leptin and apelin in HT-OB children was significantly higher than in the C and HT-NW group. A similar finding for leptin level was demonstrated in comparison of HT-NW with C group. In children with HT-OB, the lack of decline in nocturnal DBP was associated with significantly higher BMI and the Cole's Index value. Children with HT-OB and lack of decline in nocturnal SBP showed lower leptin and insulin concentrations, and lower values of HOMA-IR as compared with dipping children. Positive correlation in the whole study group was found between adipokines levels and BP measurements. In conclusion, children with primary HT show higher concentration of adipokines compared with their healthy peers. The data on relationship of serum adipokines levels with anthropometric and BP parameters in children may be helpful to clarify the sequence of disturbances in the cardiovascular system in adults, which requires further examination.

Topics: Adolescent; Apelin; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Body Mass Index; Case-Control Studies; Circadian Rhythm; Diastole; Essential Hypertension; Female; Humans; Ideal Body Weight; Insulin; Insulin Resistance; Leptin; Male; Obesity; Overweight; Retrospective Studies

During the transition from premenopause to postmenopause, many women experience weight gain and central fat deposition; therefore, we hypothesized that circulating growth factors can play a role in the pathogenesis of hypertension, metabolic syndrome, and subclinical organ damage in perimenopausal women.. The study included 192 women aged 40 to 60years; 152 had newly diagnosed essential hypertension that had never been treated, and 40 were normotensive age-matched controls. For all subjects, 24-h ambulatory blood pressure monitoring (ABPM), echocardiographic examination with assessment of left ventricular mass (LVM) and systolic and diastolic functions (GE Vivid 7.0, General Electric Vingmed Ultrasound, Horten, Norway), carotid ultrasound with measurement of intima-media thickness, and carotid-femoral pulse wave velocity (PWV) measurement (SphygmoCor, AtCor Medical, Sydney, Australia) were performed. Serum levels of insulin-like growth factor 1 (IGF-1), insulin-like growth factor-binding protein 2 (IGFBP-2), and insulin-like growth factor-binding protein 3 (IGFBP-3) were measured using an immunochemical assay.. Hypertensive women had significantly lower IGFBP-2 levels than did normotensive controls (162.9±83.7 vs. 273.1±103.0μg/L, p<0.001); the groups did not differ regarding IGF and IGFBP-3 concentrations. After adjusting the covariates, multivariate analysis showed that IGFBP2 was significantly negatively correlated with 24-h systolic blood pressure (β=-0.31, p=0.02). The adjusted odds ratio for hypertension per standard deviation decrease in IGFBP-2 was 3.43 (95% confidence interval [CI] 1.65-7.13). IGFBP-2 showed a negative correlation with the number of metabolic syndrome components. Independent of body composition, IGFBP-2 was significantly related to left ventricular relative wall thickness and the ratio of mitral inflow velocities as parameter of diastolic function.. In perimenopausal women, decreased IGFBP-2 levels may play a role in blood pressure regulation and the development of subclinical left ventricular diastolic dysfunction. Whether IGFBP-2 is a marker or a mediator of cardiovascular disease in this population merits further investigation.

Topics: Adult; Blood Pressure; Cardiovascular Diseases; Carotid Intima-Media Thickness; Echocardiography; Essential Hypertension; Female; Humans; Hypertension; Hypertrophy, Left Ventricular; Insulin-Like Growth Factor Binding Protein 2; Insulin-Like Growth Factor Binding Protein 3; Insulin-Like Growth Factor Binding Proteins; Insulin-Like Growth Factor I; Leptin; Menopause; Metabolic Diseases; Metabolic Syndrome; Middle Aged; Pulse Wave Analysis; Risk Assessment

This study was aimed to investigate the relationship between serum leptin, adiponectin, visfatin levels and obesity and essential hypertension in female subjects.. According to BMI and blood pressure, 206 female participants enrolled were divided into four groups: group 1: obesity and hypertension (48 cases); group 2: non-obesity but hypertension (48 cases); group 3: obesity and normotension (56 cases) and group 4: normal BMI and blood pressure (54 cases). Serum leptin, adiponectin and visfatin levels were detected and their relationships to BMI, blood pressure and waist circumference were analysed.. Serum leptin levels were significantly higher in non-obese groups [group 2: (4.47 ± 1.26) ng/L, group 4: (3.73 ± 1.18) ng/L] than in obese groups [group 1: (2.97 ± 1.46) ng/L, group 3: (3.02 ± 1.18) ng/L], and higher in hypertension groups than in normotension groups. Serum adiponectin levels were obviously higher in group 4 [38.99 (19.75, 103.71) µg/L] than in the other three groups. There were no significant differences in adiponectin levels among group 1, 2 and 3. Serum levels of visfatin were lower in normotension groups [group 3: 3.19 (0.96, 9.45) ng/L; group 4:3.23 (1.92, 4.64) ng/L] than in hypertension groups [group 1: 3.84 (3.40, 5.35) ng/L; group 2: 3.75(1.63, 6.67) ng/L] irrespective of obesity. Logistics regression analysis showed that there was 1.6%, 8.3%, or 5.45% increased risk for hypertension for each 1 µg/L decrease in adiponectin, 1 cm increase in waist circumference, or 1 µg/L increase in visfatin level in obesity, respectively. No relationship could be viewed between leptin and hypertension.. Adiponectin and visfatin levels were correlated with obesity and blood pressure in females. Both adipokines may play a crucial role in the development of hypertension in female obesity.

Topics: Adiponectin; Adult; Blood Pressure; Body Mass Index; Case-Control Studies; Cytokines; Essential Hypertension; Female; Humans; Hypertension; Leptin; Logistic Models; Nicotinamide Phosphoribosyltransferase; Obesity; Risk Factors; Waist Circumference