Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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The Relationship between Serum Adiponectin, Essential Hypertension, LV Mass Index, and LV Diastolic Function

혈중 Adiponectin과 본태성 고혈압, 좌심실 비대 및 이완 장애의 연관성

Hong, Soon-Jun;Park, Chang-Gyu;Park, Jae-Suk;Ahn, Jeong-Cheon;Shin, Sung-Hee;Park, Sung-Mi;Lim, Hong-Euy;Kim, Eung-Joo;Seo, Hong-Seok;Oh, Dong-Joo;Ro, Young-Moo;Jang, Yang-Soo
홍순준;박창규;박재석;안정천;신성희;박성미;임홍의;김응주;서홍석;오동주;노영무;장양수

  • Published : 20031200
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Abstract

Background and Objectives : Adiponectin is known for its anti-inflammatory and anti-atherogenic effects. The purpose of this study is to characterize the relationships among serum adiponectin, essential hypertension (EH), left ventricular mass index (LVMI), and LV diastolic function. Subjects and Methods : Serum adiponectin by RIA and body mass index were measured in 275 patients (M : F=137 : 138). We calculated LVMI, E/A ratio, deceleration time (DT), and isovolumetric relaxation time (IVRT) by using echocardiograms. Results : The serum adiponectin level of the hypertensive group was significantly lower than that of the non-hypertensive group (9.9${\pm}$9.8 ug/mL vs. 12.9${\pm}$9.5 ug/mL, p<0.05). Plasma adiponectin was negatively correlated with LVMI (r=-0.329, p<0.001), BMI (r=-0.290, p<0.001), and IVRT (r=-0.485, p<0.05), but was positively correlated with E/A (r=+0.359, p<0.001). Conclusion : These results suggest that a decrease in serum adiponectin is associated with an increase in blood pressure and BMI, progress of LVH, and decrease in LV diastolic function.

배경 및 목적 : 최근에 인체 지방조직에서 adiponectin이라는 새로운 단백질을 발견하게 되었으며, adiponectin이 좌심실 비대와 이완 장애에 미치는 영향에 대한 연구는 전무한 실정이다. 본 연구의 목적은 혈중 adiponectin과 본태성 고혈압과의 관계를 알아보고, 좌심실 비대 및 이완 장애와 혈중 adioponectin의 연관성을 알아보고자 하였다. 방 법 : 고려대 구로병원에 내원한 275명의 환자(남 : 여=137 : 138)를 대상으로 하였고, 평균 연령은 56.7${\pm}$ 12.3세(20${\sim}$87세)였다. 좌심실 질량(left ventricular mass)의 경우 Devereux's formula를 이용하여 측정하였으며, 좌심실 질량 지수(left ventricular mass index : LVMI)의 경우 좌심실 질량을 체표면적으로 나눠서 구하였다. 좌심실 이완기능은 E/A, DT, IVRT로 평가하였으며, 혈중 adiponectin 수치는 RIA kit(The LINCO Research, Inc.,Missouri, USA)를 이용하여 측정하였다. 결 과 : 고혈압군에서 혈중 adiponectin이 9.9${\pm}$9.8 ug/mL로 비고혈압군의 12.9${\pm}$9.5 ug/mL에 비해 유의하게 낮은 수치를 보여주었다(p<0.05). 고혈압군에서 좌심실 질량 지수(LVMI)가 117.3${\pm}$35.4 g으로 비고혈압군의 97.0${\pm}$18.7g보다 유의하게 높은 수치를 보였다. 심장의 이완 장애를 시사하는 E/A ratio의 경우 고혈압군에서 유의하게 낮았다(p<0.05). 혈중 adiponectin과 좌심실 질량 지수(LVMI)사이에는 역상관 관계(r=-0.329, p<0.001)가 있었고, 균등용적 이완 시간(IVRT)과도 뚜렷한 역상관 관계(r=-0.485, p<0.05)를 보였다. 다변량 선형회귀분석에서도 좌심실 질량 지수(LVMI)($\beta$= -0.285, p<0.05)는 혈중 adiponectin수치와 유의한 역상관 관계를 보였다. 결 론 : 혈중 adiponectin이 감소할수록 좌심실 비대가 심해지며, 혈중 adiponectin은 혈압과의 역상관 관계를 나타냈다. 따라서 본 연구는 고혈압 환자에서 혈중 adiponectin의 감소는 좌심실 비대 및 이완 장애와 연관이 있어 심혈관질환의 위험인자로 작용할 가능성을 시사하며 혈중 adiponectin 수치가 낮을 경우 심혈관질환의 예방을 위해 보다 적극적인 혈압 조절의 필요성을 제시하고 있다.

Keywords

References

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