Circulating levels of adiponectin, leptin, and tumour necrosis factor α in hypertension

Figures & data

Table I.  Circulating concentrations of adiponectin, leptin, and tumour necrosis factor α amongst 278 patients treated for hypertension (ASCOT trial participants).

			Adiponectin (ng/mL)			Leptin (pg/mL)			Tumour necrosis factor α (pg/mL)
Patient characteristics		n	Median	25th percentile	75th percentile	Median	25th percentile	75th percentile	Median	25th percentile	75th percentile
Age group	45–54 yrs	27	2600	1331	4341	950	306	1697	21	13	51
	55–64 yrs	115	2220	1103	3799	687	304	1400	23	13	181
	65–74 yrs	101	2509	1259	4336	478	265	1544	26	12	171
	75+ yrs	19	1684	1125	4200	910	424	1800	17	11	141
Gender	Male	36	1842	1093	4200	1740	1112	2639	16	12	53
	Female	237	2400	1250	4125	502	275	1262	25	13	177
Body mass index	<27 kg/m^2	94	2585	1268	4606	450	235	1364	28	14	175
	≥27 kg/m^2	175	2220	1122	3733	683	349	1547	22	13	129
Smoking habit	Non-smoker	216	2400	1266	4200	472	264	1382	25	14	185
	Smoker	57	2386	1371	4066	705	258	1697	17	8	40
Diabetes	No	221	2480	1259	4332	549	282	1470	23	13	131
	Yes	52	1572	992	2998	709	326	1610	37	10	243
Fasting plasma	<6.1 mmol/L	17	2434	1254	4200	460	255	1566	25	15	146
glucose^a	≥6.1 mmol/L	130	2376	1313	3861	582	287	1240	19	12	81
Left ventricular hypertrophy	No	252	2434	1282	3989	479	267	1382	22	14	83
	Yes	21	1837	1150	4578	550	140	1756	222	14	793
Hypertension grade	Normal	107	2085	1113	3908	549	290	1333	24	14	106
	High norma	52	2231	1367	3782	485	328	1410	56	14	252
	Mild	89	2349	1106	4200	617	259	1610	22	13	155
	Moderate	22	3883	1523	4699	716	258	3680	19	4	27
Previous cardiovascular event	No	233	2400	1250	4125	600	300	1547	24	13	133
	Yes	40	1628	1095	4207	534	288	1425	37	12	163
Target organ damage	No	233	2287	1250	4036	600	304	1561	23	13	111
	Yes	37	2500	1079	4406	516	282	1259	68	12	185
Angiotensin-converting enzyme inhibitor therapy	No	148	2088	1075	4265	687	338	1676	21	12	101
	Yes	125	2412	1367	3903	494	260	1280	33	14	195
Beta-blocker therapy	No	151	2400	1357	4281	551	262	1547	25	13	163
	Yes	122	2201	1077	3931	604	365	1516	23	13	128
Statin therapy	No	113	2685	1405	4285	711	327	1621	33	15	219
	Yes	159	2118	1058	3888	516	268	1459	21	12	91
Antiplatelet therapy	No	155	2170	1225	4125	533	295	1582	23	13	101
	Yes	111	2462	1179	4207	665	293	1298	33	13	193
More than three metabolic risk factors	No	126	2211	1229	4957	509	282	1541	28	12	155
	Yes	132	1870	1113	3572	479	315	1183	19	13	115
Kidney function^b	Normal	177	2417	1307	4066	573	265	1541	22	14	124
	Poor	70	2351	1266	4200	457	253	940	26	14	102

Data in columns show the median and interquartile ranges for each adipocytokine against various demographic and pathological factors that appear in the rows.

For adiponectin, there were significant differences by diabetes (P=0.01), impaired fasting glucose (P=0.001) and statin therapy (P=0.02). For leptin, there were significant differences by gender (P<0.001), beta-blocker therapy (P=0.03), and fasting plasma glucose (P<0.001). For tumour necrosis factor α, there were significant differences by left ventricular hypertrophy (P=0.016).

^a Excludes patients with diabetes.

^b Normal: glomerular filtration rate estimate by MDRD > 60 mL/min; Poor:≤60 mL/min.

MDRD = Modification of Diet in Renal Disease; ASCOT = Anglo-Scandinavian Cardiac Outcomes Trial

Table IIA.  Adipocytokines and characteristics of healthy controls compared with treated hypertension patients (ASCOT trial participants) compared with untreated, newly diagnosed hypertensives.

	Healthy controls (n=55)		ASCOT patients (n=198)		Untreated hypertensives (n = 54)
Age (years)	48.3	(12.3)	62.8	(7.7)^b	61.4	(10.9)
% Male gender	60.0	(33)	90.4	(179)^b	64.8	(35)
% Smokers	20.0	(11)	21.0	(43)	35.2	(19)
Body mass index (kg/m^2)	25.7	(5.5)	27.7	(2.8)^a	26.3	(5.1)
Systolic BP (mmHg)	124	(10)	137	(16)^b	153	(14)^b
Diastolic BP (mmHg)	78.6	(6.2)	75.9	(10.6)	91.4	(8.8)^b
Pulse pressure (mmHg)	45.5	(7.2)	60.9	(13.3)^b	61.2	(14.0)
Mean arterial pressure (mmHg)	93.8	(6.9)	96.1	(11.0)	111.8	(8.5)^b
Fasting plasma glucose (mmol/L)	5.00	(0.53)	6.31	(1.82)^b	4.97	(0.47)^b
Serum cholesterol (mmol/L)	5.00	(1.02)	4.54	(1.02)^a	5.24	(0.93)
Fasting serum triglycerides (mmol/L)	0.90	(0.70, 1.50)	1.20	(0.80, 1.90)^b	1.10	(0.88, 1.40)
HDL cholesterol (mmol/L)	1.45	(0.33)	1.44	(0.41)	1.44	(0.36)
Adiponectin (ng/mL)	3542	(2475, 4961)	1855	(1147, 3681)^b	3921	(2958, 5175) ^b
Leptin (pg/mL)	6692	(3172, 13428)	439	(271, 935)^b	6594	(3070, 11456) ^b
Tumour necrosis factor α (pg/mL)	220	(31, 648)	20	(13, 74)^b	120	(4, 821)

Data are percent (n), mean (SD) or median (interquartile range). P-value corresponds to chi-square and t test (or Mann-Whitney equivalent): healthy controls versus ASCOT patients or ASCOT patients versus untreated hypertensives.

Patients with diabetes or with a previous cardiovascular event were excluded.^aP<0.05; ^bP<0.001.

ASCOT = Anglo-Scandinavian Cardiac Outcomes Trial; BP = Blood Pressure; HDL = High Density Lipoprotein

Table IIB.  Adipocytokines of male patients with hypertension without diabetes and without a previous cardiovascular event compared with matched controls.

	Controls (n=56)		Patients with treated hypertension (n=56)		Patients with untreated hypertension (n=54)
Age (years)	57.4	(11.5)	56.9	(6.8)	61.4	(10.9)	0.80
Adiponectin (ng/mL)	3788.328	(2491–4466)	2234.5	(1315–4413)	3921	(2958–5175)	0.003
Leptin (pg/mL)	5054.375	(2557–7498)	375.5	(252–1081)	6594	(3070–11456)	<0.001
Tumour necrosis factor α (pg/mL)	157.005	(5–1157)	23.8	(14.2–83)	120	(4–821)	0.030

Data are median (interquartile range). P-value relates to differences between controls and patients with treated hypertension (ASCOT).

ASCOT = Anglo-Scandinavian Cardiac Outcomes Trial.

Figure 1.  Median circulating adiponectin levels by obesity status in male and female hypertension patients and controls.

Table III.  Cardiovascular risk factors, cardiovascular medication and adipocytokines in male hypertension patients (ASCOT trial participants) by obesity status.

	Patients with hypertension
Cardiovascular risk factors and adipocytokines	Non-obese (n=64)		Obese (n=120)		P
Age (years)	59.9	(6.6)	60.1	(6.0)	0.84
Smoking history (%)	29.7	(19)	24.2	(29)	0.26
Body mass index (kg/m^2)	25.3	(1.5)	31.5	(3.9)	<0.001
History of diabetes (%)	10.9	(7)	20.8	(25)	0.07
History of previous cardiovascular event (%)	15.6	(10)	13.3	(16)	0.67
Angiotensin-converting enzyme inhibitor therapy (%)	42.2	(27)	52.5	(63)	0.12
Beta-blocker therapy (%)	45.3	(29)	45.0	(54)	0.54
Statin therapy (%)	56.3	(36)	64.2	(77)	0.19
Systolic BP (mmHg)	133.5	(14.3)	138.7	(16.2)	0.03
Diastolic BP (mmHg)	75.0	(9.0)	77.3	(10.3)	0.15
Pulse pressure (mmHg)	58.5	(12.5)	61.4	(12.7)	0.13
Mean arterial pressure (mmHg)	94.5	(9.33)	97.8	(11.07)	0.05
Fasting plasma glucose (mmol/L)	6.21	(2.00)	6.49	(2.03)	0.40
Serum cholesterol (mmol/L)	4.69	(1.18)	4.60	(1.06)	0.60
Fasting serum triglycerides (mmol/L)^a	1.10	(0.70, 1.50)	1.30	(0.90, 1.90)	0.03
HDL cholesterol (mmol/L)	1.44	(0.41)	1.43	(0.42)	0.82
Total/HDL cholesterol ratio	3.49	(1.38)	3.93	(5.71)	0.57
Adiponectin (ng/mL)^a	2471	(1267, 4959)	2085	(1079, 3681)	0.17
Leptin (pg/mL)^a	370	(260, 922)	475	(303, 968)	0.38
Tumour necrosis factor α (pg/mL)^a	41	(15, 164)	27	(14, 185)	0.46

Data are percent (n), mean (SD). P-value corresponds to chi-square and independent t test (or ^a Mann-Whitney equivalent)

^a Data are median (interquartile range).

ASCOT = Anglo-Scandinavian Cardiac Outcomes Trial; BP = Blood Pressure; HDL = High Density Lipoprotein

Table IV.  Area under the curve for discriminators of hypertension amongst males without diabetes and without a previous cardiovascular event.

	Area under the curve (95% CI)	P
Fasting plasma glucose	81.1% (75.0–87.1%)	<0.001
Serum cholesterol	41.2% (33.1–49.3%)	0.06
Fasting serum triglycerides	60.8% (52.1–69.5%)	0.019
HDL cholesterol	48.3% (40.0–56.6%)	0.72
Adiponectin	28.1% (21.2–34.9%)	<0.001
Leptin	3.8% (1.5–6.2%)	<0.001
Tumour necrosis factor α	32.0% (22.4–41.6%)	<0.001
Adiponectin:leptin ratio	87.0% (82.2–91.7%)	<0.001

HDL = High Density Lipoprotein

Figure 2.  Median circulating adiponectin levels by hypertension grade status in hypertension patients (ASCOT). (1 = normal: systolic BP ≤ 120 mmHg, diastolic BP ≤ 80 mmHg; 2 = high-normal: systolic BP between 135 and 139 mmHg, diastolic BP between 85 and 89 mmHg; 3 = mild hypertension: systolic BP between 140 and 159 mmHg, diastolic BP between 90 and 99 mmHg; 4 = moderate hypertension: systolic BP between 160 and 179 mmHg, diastolic BP between 100 and 109 mmHg; 5 = severe hypertension: systolic BP > 180 mmHg, diastolic BP > 110 mmHg.). ASCOT = Anglo-Scandinavian Cardiac Outcomes Trial; BP = Blood Pressure