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首页> 外文期刊>Hypertension: An Official Journal of the American Heart Association >Adiponectin levels and the risk of hypertension: A systematic review and meta-analysis
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Adiponectin levels and the risk of hypertension: A systematic review and meta-analysis

机译：脂联素水平与高血压风险：系统评价和荟萃分析

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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). 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.
机译：动物研究和人的小型对照研究表明，脂联素可能通过脑介导和内皮介导的机制调节血压。我们进行了系统的综述和荟萃分析，以评估自由活动成年人群中血浆脂联素水平和高血压的流行病学证据。截至2013年2月，对MEDLINE和EMBASE的系统搜索确定了43项无前瞻性研究和5项前瞻性研究，其中包括17 598名成人（8220患有高血压;平均年龄19-69岁;平均体重指数22-38 kg / m）。两名研究者通过高血压状态和剂量反应关系独立提取了脂联素水平数据。我们使用随机效应模型计算高血压成人和血压正常成人之间脂联素水平的加权均值差，并使用2阶段广义最小二乘趋势方法计算脂联素每升高1μg/ mL高血压的比值比。高血压成年人的脂联素水平比正常血压成年人低1.64μg/ mL（95％置信区间，-2.07，-1.21）。脂联素水平每升高1μg/ mL，高血压风险降低6％（95％置信区间，0.92，0.97）。这些发现在研究设计和特征（包括年龄，性别和体重指数）中是一致的（P> 0.05）。然而，我们的荟萃分析受到无法解释的大量研究间异质性，少量前瞻性研究以及选择性报告剂量反应数据的限制。总之，流行病学证据表明血浆脂联素水平是肥胖相关高血压发展的生物标志物和可能的介质。脂联素作为潜在的治疗靶标及其在血压调节中与其他脂联素之间的关系仍然是个问题。

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