Published Online
on April 23, 2007

A more recent version of this article appeared on June 1, 2007

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Submitted on January 3, 2007
Revised on January 18, 2007

Hypoadiponectinemia as a Predictor for the Development of Hypertension. A 5-Year Prospective Study

Wing-Sun Chow; Bernard M.Y. Cheung; Annette W.K. Tso; Aimin Xu; Nelson M.S. Wat; Carol H.Y. Fong; Liza H.Y. Ong; Sidney Tam; Kathryn C.B. Tan; Edward D. Janus; Tai-Hing Lam; and Karen S.L. Lam^*

From the Department of Medicine (W-S.C., B.M.Y.C., A.W.K.T., A.X., N.M.S.W., C.H.Y.F., L.H.Y.O., K.C.B.T., K.S.L.L.), the Research Centre of Heart, Brain, Hormone, and Healthy Aging (B.M.Y.C., A.X., K.C.B.T., K.S.L.L.), the Clinical Biochemistry Unit (S.T., E.D.J.), and the Department of Community Medicine (T-H.L.), University of Hong Kong, Queen Mary Hospital, Hong Kong, People’s Republic of China. Current address: Department of Medicine (E.D.J.), University of Melbourne, Western Hospital, Footscray, Australia.

^* To whom correspondence should be addressed. E-mail: ksllam{at}hkucc.hku.hk.

Abstract--Low circulating levels of adiponectin, an adipokine with insulin-sensitizing, antiatherogenic, and anti-inflammatory properties, are found in hypertensive patients. Adiponectin replenishment ameliorated hypertension in adiponectin-deficient mice or obese, hypertensive mice with hypoadiponectinemia, suggesting an etiologic role of adiponectin in hypertension. We aimed to determine, in this 5-year prospective study, whether hypoadiponectinemia could predict the development of hypertension in a nondiabetic Chinese cohort. A total of 577 subjects (249 men and 328 women) were recruited from the population-based Hong Kong Cardiovascular Risk Factor Prevalence Study and prospectively followed up for 5 years. The relationship of serum adiponectin with the development of hypertension (sitting blood pressure 140/90 mm Hg) was investigated in a nested case-control study consisting of 70 subjects who had developed hypertension on follow-up and 140 age- and sex-matched control subjects who were normotensive both at baseline and at year 5. At baseline, serum adiponectin level in the lowest sex-specific tertile was more likely to be associated with hypertension (P=0.003 versus the highest tertile, after adjusting for age, body mass index, fasting insulin, and high-sensitivity C-reactive protein). At year 5, baseline serum adiponectin was a significant independent predictor of incident hypertension in the nested case-control study (P=0.015; age adjusted), together with mean arterial pressure (P<0.001), high-sensitivity C-reactive protein (P=0.018), and body mass index (P=0.004). Normotensive subjects with baseline serum adiponectin levels in the lowest sex-specific tertile had an increased risk of becoming hypertensive (adjusted odds ratio: 2.76; 95% CIs: 1.06 to 7.16; P=0.037 versus highest tertile). Our data suggest that hypoadiponectinaemia may be involved in the pathogenesis of hypertension in humans.

Key words: adiponectin • hypertension • Chinese • prediction • C-reactive protein

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Hypoadiponectinemia: A Novel Link Between Obesity and Hypertension?

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