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  • Special Issue: Current evidence and perspectives for hypertension management in Asia
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The associations of adipokines with hypertension in youth with cardiometabolic risk and the mediation role of insulin resistance: The BCAMS study

Hypertension Research volume 46, pages 1673–1683 (2023)Cite this article

Abstract

The mechanisms link obesity and hypertension are not well understood. One possibility is the alterations in adipose-derived adipokines that modulate insulin resistance (IR) and cardiovascular homeostasis. We aimed to assess the associations between hypertension and four adipokine levels in Chinese youth, and to examine to what extent the associations are mediated by IR. We utilized cross-sectional data from the Beijing Children and Adolescents Metabolic Syndrome (BCAMS) Study Cohort (n = 559, mean age = 20.2 years). Plasma leptin, adiponectin, retinol binding protein 4 (RBP4) and fibroblast growth factor 21 (FGF21) levels were assayed. The relationships between adipokines and hypertension and the possible mediation effect of IR were evaluated. Youth with hypertension have lower adiponectin and higher leptin, FGF21 (all P < 0.001) and RBP4 levels (p = 0.06) compared to their counterparts. Moreover, the co-existence of these two or more adipokine abnormalities in youth leads to a 9-fold increased risk for hypertension (OR: 9.19; 95% CI, 4.01–21.08) compared with these without abnormalities. However, in the fully adjusted and BMI-adjusted analyses, only FGF21 was a significant predictor of hypertension (OR: 2.12; 95% CI, 1.34–3.36). Mediation analysis revealed that the associations between leptin, adiponectin, RBP4 and hypertension are totally mediated by IR (proportion: 63.9%, 65.4%, and 31.6%, respectively), while BMI and IR partly mediated the association between FGF21 and hypertension (proportion: 30.6%, 21.2%). Our findings suggest that dysregulation of adipokines might result in hypertension in youth. Leptin, adiponectin and RBP4 may exert their functions in hypertension through adiposity-related IR, whereas FGF21 might be used as an independent marker of hypertension in youth.

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Acknowledgements

We thank Dr. Jie Mi, the professor of Capital Institute of Pediatrics in Beijing, and other BCAMS study members and participants for their continuing participation in this research effort. This work was supported by grants from National Natural Science Foundation of China (81970732), Capital’s Funds for Health Improvement and Research (2020-2Z-40117), the CAMS Innovation Fund for Medical Sciences (CIFMS 2021-I2M-1-016) and the National High Level Hospital Clinical Research Funding (2022-PUMCH-C-014), the key program of Beijing Municipal Science & Technology Commission (D111100000611001, D111100000611002).

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  1. These authors contributed equally: Bo Li, Cong Hou.

Authors and Affiliations

  1. Department of Endocrinology, National Health Commission (NHC) Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China

    Bo Li & Ming Li

  2. Department of Endocrinology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China

    Cong Hou & Lianxia Li

  3. Department of endocrinology, Xuanwu Hospital, Capital Medical University, Beijing, China

    Shan Gao

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Contributions

BL and CH analyzed data and wrote the manuscript. LL and CH contributed to data collection in the BCAMS; SG was responsible for the follow-up study and contributed to interpretation of the data, and revised the manuscript; ML was responsible for the concept, design of the work, and contributed to interpretation of the data, and revised the manuscript. All authors read and approved the final manuscript.

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Correspondence to Ming Li or Shan Gao.

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The studies involving human participants were reviewed and approved by the Ethics Committee of Peking Union Medical College Hospital. Written informed consent to participate in this study was provided by the participants’ legal guardian/next of kin.

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Li, B., Hou, C., Li, L. et al. The associations of adipokines with hypertension in youth with cardiometabolic risk and the mediation role of insulin resistance: The BCAMS study. Hypertens Res 46, 1673–1683 (2023). https://doi.org/10.1038/s41440-023-01243-9

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