Relation of Microalbuminuria to Adiponectin and Augmented C-Reactive Protein Levels in Men With Essential Hypertension

Tsioufis, Costas; Dimitriadis, Kyriakos; Chatzis, Dimitrios; Vasiliadou, Carmen; Tousoulis, Dimitrios; Papademetriou, Vasilios; Toutouzas, Pavlos; Stefanadis, Christodoulos; Kallikazaros, Ioannis

doi:10.1016/j.amjcard.2005.05.052

Cited by 127 publications

(107 citation statements)

References 30 publications

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“…A growing amount of data support the interrelationship of eGFR with inflammatory involvement as well as a distinct role of low-grade inflammation in the progression of chronic kidney disease 3,9,14,15 and diffuse atherosclerosis reflected by microalbuminuria. 25,26 In these lines, although resistin mediates diverse biological effects of cytokines, [27][28][29] there was a lack of association between resistin and white blood cell count in our population, a finding that is in contrast with previous reports. 6,28 It should be noted that other more sensitive markers of subclinical inflammation such as C-reactive protein were not estimated in this study, thus the link between hyperresistinemia and inflammation may be missed.…”

Section: Discussioncontrasting

confidence: 99%

Independent association of circulating resistin with glomerular filtration rate in the early stages of essential hypertension

et al. 2009

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Resistin, a newly discovered protein, promotes endothelial dysfunction and proinflammatory activation, contributing to subclinical atherosclerosis in different clinical settings. In this study we sought to investigate the relationship of increased resistin levels with estimated glomerular filtration rate (eGFR), the most established marker of kidney impairment, in hypertensive subjects. Our population consisted of 132 untreated non-diabetic subjects with stage I-II essential hypertension (49 males, mean age ¼ 54 years, office blood pressure (BP) ¼ 159/100 mm Hg). In all patients eGFR was assessed by the Modification in Renal Disease equation and venous blood sampling was performed for estimation of resistin concentrations. The distribution of resistin was split by the median (4.63 ng ml À1 ) and accordingly subjects were stratified into those with high and low values. Hypertensive patients with high (n ¼ 66) compared to those with low resistin (n ¼ 66) exhibited lower eGFR values (77.1±9.4 vs 89.1±12.2 ml min À1 per 1.73m 2 , Po0.0001), even after adjustment for established confounders. In the total population, resistin was associated with 24-h systolic BP (r ¼ 0.244, Po0.05), serum creatinine (r ¼ 0.311, P ¼ 0.007) and eGFR (r ¼ À0.519, Po0.0001). Multiple regression analysis revealed that age (b ¼ 0.379, P ¼ 0.01), body mass index (b ¼ 0.158, P ¼ 0.022), 24-h systolic BP (b ¼ 0.284, P ¼ 0.006) and resistin (b ¼ 0.429, Po0.0001) were independent predictors of eGFR (R 2 ¼ 0.436, Po0.0001). In essential hypertensive subjects, higher resistin levels are associated with renal function impairment, as reflected by decreased eGFR. Moreover, the independent association of resistin with eGFR suggests involvement of resistin in the progression of kidney damage in the early stages of hypertension.

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Section: Discussioncontrasting

confidence: 99%

Independent association of circulating resistin with glomerular filtration rate in the early stages of essential hypertension

et al. 2009

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“…A role for inflammation as a mechanistic link between microalbuminuria and vascular dysfunction has also been proposed. 35,45 Regardless of the mechanism involved, the present finding of an association between abnormalities in brachial artery (a 'peripheral' conduit artery) function and urinary albumin excretion underscores the generalized nature of vascular dysfunction in persons with essential hypertension.…”

Section: Discussionmentioning

confidence: 63%

Urinary albumin excretion is associated with impaired flow- and nitroglycerin-mediated brachial artery dilatation in hypertensive adults

et al. 2007

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We investigated whether the urinary albumin/creatinine ratio (UACR), a measure of albuminuria, is associated with non-invasive measures of arterial function in hypertensive adults without known coronary heart disease (CHD) or stroke. UACR was measured in the first voided morning urine sample in 469 non-Hispanic white hypertensive individuals (mean age 62.279.8 years, 41% men) belonging to hypertensive sibships. High-resolution ultrasonography of the brachial artery was used to assess flow-mediated dilatation (FMD) -an endothelium-dependent response -and nitroglycerin-mediated dilatation (NMD) -an endothelium-independent response. Because of skewed distribution, UACR was log transformed after addition of 0.1. The association of log (UACR þ 0.1) with FMD and NMD, before and after adjustment for CHD risk factors, serum creatinine, and hypertension medication and statin use was assessed using linear regression analyses. In univariable analyses, variables associated with lower FMD were greater age, male sex, history of smoking, lower high-density lipoprotein (HDL) cholesterol, higher serum creatinine and higher log (UACR þ 0.1); variables associated with lower NMD were greater age, male sex, higher systolic blood pressure, lower HDL cholesterol, higher serum creatinine and higher log (UACR þ 0.1). In separate stepwise multivariable regression analyses that adjusted for conventional CHD risk factors, serum creatinine and hypertension medication and statin use, higher log (UACR þ 0.1) was associated with lower brachial artery FMD (P ¼ 0.035) and NMD (P ¼ 0.0002). These findings highlight the association of increased urinary albumin excretion with impaired vascular reactivity in hypertensive individuals.

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“…One could suggest that the protective to the endothelium and anti-atherosclerotic properties of the Mediterranean diet (Willett et al, 1995;Trichopoulou and Lagiou, 1997;Panagiotakos et al, 2003Panagiotakos et al, , 2007Psaltopoulou et al, 2004;Serra-Majem et al, 2004;Trichopoulos and Lagiou, 2004;Estruch et al, 2006;Karlin et al, 2008;Barceló et al, 2009; Nú ñez-Có rdoba et al, 2009) could be the pathophysiological explanation for the observed relation of the level of adherence to this favorable diet and decreased urinary albumin excretion. It is also established that the Mediterranean food pattern is related to reduced inflammatory activation (Carter et al, 2010) that in its own turn is associated with attenuated levels of albuminuria as previously shown (Tsioufis et al, 2004;Tsioufis et al, 2005). Moreover, taking into consideration that albuminuria reflects diffuse vascular dysfunction, (Tsioufis et al, 2004(Tsioufis et al, , 2005) the higher the KIDMED score the lower the level of impairment of the vascular tree even at this early stage of the proatherosclerotic process.…”

Section: Discussionmentioning

confidence: 86%

“…It is also established that the Mediterranean food pattern is related to reduced inflammatory activation (Carter et al, 2010) that in its own turn is associated with attenuated levels of albuminuria as previously shown (Tsioufis et al, 2004;Tsioufis et al, 2005). Moreover, taking into consideration that albuminuria reflects diffuse vascular dysfunction, (Tsioufis et al, 2004(Tsioufis et al, , 2005) the higher the KIDMED score the lower the level of impairment of the vascular tree even at this early stage of the proatherosclerotic process.…”

Section: Discussionmentioning

confidence: 86%

“…In adult populations, albuminuria constitutes, apart from established target organ damage in hypertension, a potent marker of atherosclerosis progression, diffuse endothelial dysfunction and increased cardiovascular risk (Hillege et al, 2001;Tsioufis et al, 2004;Tsioufis et al, 2005;Arnlöv et al, 2005). The study of albuminuria in adolescents before the onset of overt adult clinical disease, although currently limited to diabetic adolescents, (Rademacher et al, 2008;Rademacher and Sinaiko, 2009) is attractive allowing recognition of pro-atherosclerotic predictors in a free of disease-burden setting.…”

Section: Introductionmentioning

confidence: 99%

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Adherence to the Mediterranean diet and albuminuria levels in Greek adolescents: data from the Leontio Lyceum ALbuminuria (3L study)

et al. 2010

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Background/Objectives: Mediterranean diet has favorable effects on the cardiovascular system, whereas albuminuria is associated with atherosclerosis progression. The aim of the study was to assess the relationships of adherence rates to the Mediterranean diet with albumin to creatinine ratio (ACR), in a cohort of Greek adolescents who participated in the Leontio Lyceum ALbuminuria (3L) study. Subjects/Methods: In a total of 365 adolescents 12-17 years of age included in 3L study, ACR values were determined in a morning-spot urine. Results: The Mediterranean diet Quality Index for children and adolescents (KIDMED) was estimated and accordingly subjects were divided into those with high (X8), average (4-7) and low (p3) score. Adolescents with low (n ¼ 153, 42%) compared with those with average (n ¼ 187, 51.2%) and high (n ¼ 25, 6.8%) KIDMED score were characterized by greater ACR values (22.4 vs 13.4 vs 12.1 mg/g, Po0.05) even after adjustment for confounders. In the total population, KIDMED score was related to body mass index (r ¼ 0.122, P ¼ 0.02), waist circumference (r ¼ 0.118, P ¼ 0.02), systolic blood pressure (BP) (r ¼ 0.119, P ¼ 0.023), whereas it was negatively associated with ACR (r ¼ À0.111, P ¼ 0.041). Regarding ACR, it was associated with age (r ¼ À0.11, P ¼ 0.044), male sex (r ¼ 0.16, P ¼ 0.003), body mass index (r ¼ À0.131, P ¼ 0.016) and systolic BP (r ¼ À0.144, P ¼ 0.008). Conclusions: Adolescents who adhere to the Mediterranean diet exhibit lower levels of albuminuria, independently of demographic and hemodynamic confounders. The inverse relation of KIDMED index with ACR suggests a close link of accelerated vascular damage reflected by albuminuria with low adherence to this favorable diet of the Mediterranean basin.

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Relation of Microalbuminuria to Adiponectin and Augmented C-Reactive Protein Levels in Men With Essential Hypertension

Cited by 127 publications

References 30 publications

Independent association of circulating resistin with glomerular filtration rate in the early stages of essential hypertension

Independent association of circulating resistin with glomerular filtration rate in the early stages of essential hypertension

Urinary albumin excretion is associated with impaired flow- and nitroglycerin-mediated brachial artery dilatation in hypertensive adults

Adherence to the Mediterranean diet and albuminuria levels in Greek adolescents: data from the Leontio Lyceum ALbuminuria (3L study)

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