Increased apolipoprotein A-I levels mediate the development of prehypertension among Turks

Abstract

Objective: We aimed to assess whether apolipoprotein (apo) A-I levels that generated type-2 diabetes and coronary disease among Turks contribute to prehypertension and hypertension. Methods: A population-based sample of 2207 adults (mean age 53±11 years) was studied prospectively over a 6.5 years' follow-up. Individuals with hypertension and/or prehypertension were excluded at baseline. Results: At baseline, levels of apoA-I increased in each sex, from the normotensive to prehypertensive and hypertensive group (by mean 7.6 mg/dL, p<0.001) concomitantly with age, waist circumference, fasting triglycerides, apoB, C-reactive protein (CRP) and homeostasis model assessment. In logistic regression models, adjusted for confounders comprising waist circumference or triglycerides, prehypertension was predicted independently by apoA-I at RRs of 1.23 (95%CI 0.97; 1.52)] or 1.32 (95%CI 1.04; 1.74), respectively. Despite showing a positive association, apoA-I did not independently predict in similar models the development of hypertension; the determinants were rather waist circumference, or fasting triglycerides or CRP [RR 1.16 (95%CI 1.05; 1.28)] and, in women, diabetes. In a linear regression analysis for circulating apoA-I including 10 variables, apoB and in men systolic blood pressure were positively associated. Conclusion: In contributing to prehypertension, the pro-inflammatory apoA-I, mediated by apoB, is independent of triglyceridemia. Other inflammatory processes conjointly are likely mechanistically involved in the development of hypertension in a population with prevalent metabolic syndrome. (Anadolu Kardiyol Derg 2013; 13: 306-14) Key words: Apolipoproteins, C-reactive protein, diabetes type-2, obesity, prehypertension, systemic inflammation, regression analysis Original Investigation Özgün Araşt›rma 306ÖZET Amaç: Türk yetişkinlerinde, tip 2 diyabete ve koroner kalp hastalığına sürüklediği gösterilen apolipoprotein (apo) A-I düzeylerinin prehipertansiyon ve hipertansiyonla ilişkili olup olmadığı araştırılmaya değerdir. Yöntemler: Popülasyona dayalı bir örneklem (2207 kişi, ort. yaş 53±11) öne dönük biçimde 6.5 yıl boyunca izlendi. Başlangıçta hipertansiyon ve/ veya prehipertansiyonu olan bireyler dışlandı. Bulgular: Başlangıçtaki apoA-I düzeyleri her iki cinsiyette, yaş, bel çevresi, açlık trigliseridleri, apoB, C-reaktif protein (CRP) ve homeostaz model değerlendirmesi ile birlikte, normotansif gruptan, prehipertensif ve hipertansif gruplara doğru (ort. 7.6 mg/dL, p<0.001) yükseldi. Bel veya trigliseridin katıldığı kovaryatlar için ayarlanan lojistik regresyon modellerinde, prehipertansiyon apoA-I tarafından bağımsız olarak [1.23 (%95 GA 0.97; 1.52)] veya 1.32'lik (%95 GA 1.04; 1.74) nisbi risk oranlarıyla öngörüldü. Pozitif ilişkisine rağmen, apoA-I benzer modellerde hipertansiyon gelişmesini bağımsız olarak öngörmedi; belirleyiciler daha ziyade bel çevresi veya açlık trigliseridi veya CRP [RR 1.16 (%95 GA 1.05; 1.28)] ve kadında, diyabet idi. Serum apoA-I için 10 değişkenden oluşan bir lineer regresyon...

Apolipoprotein-A1 as a Damage-Associated Molecular Patterns Protein in Osteoarthritis: Ex Vivo and In Vitro Pro-Inflammatory Properties

“…ApoA1 is usually considered as an anti-inflammatory and atheroprotective agent [ 24 ]. However, it was recently demonstrated that high ApoA1 levels could predict the development of prehypertension [ 25 ] and type-2 diabetes [ 26 ]. Presence of ApoA1 was also observed in amyloid deposit of knee joint menisci and in acute gouty arthritis [ 27 , 28 ].…”

“…Onat et al . have also declared that ApoA1 could be converted into pro-inflammatory particles by aggregation to lipoprotein (a) Lp(a) [ 25 ]. They recently observed that low circulating Lp(a) associated with high ApoA1/HDL-C ratio were predicting factors for hypertriglyceridemic waist phenotype, which is considered as the core of the metabolic syndrome in impacting coronary heart disease risk [ 32 ].…”

Autoimmune activation as a determinant of atrial fibrillation among Turks

“…The requirement of substantial fibrosis of the right atrium may well be a consequence of autoimmune activation, analogous to the gradual development of fibrosis in chronic steatohepatitis. Prolonged BP elevation mediated by the autoimmune process [ 48 ] may also contribute to myocardial hypertrophy and to atrial fibrosis leading to incident AF. In the future, 3-dimensional speckle tracking echocardiography may be helpful in detecting atrial fibrosis as well as ventricular remodeling.…”

Breastfeeding: A bystander marker of improvement in multiparity-induced cardiometabolic disease risk?

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“…This process is determined by genetics and race and is driven by excess adiposity, MIF and Lp(a) levels and whether and to the extent to which autoimmune activation is involved. 24 In order to better elucidate the degree of the role of this maternal substrate, there is a need for future research directed at the analysis of the elements of oxidative stress during gestation, postpartum and lactation, as well as the association of these findings with subsequent cardiometabolic risk, in different ethnicities/races and population segments that are prone to impaired glucose tolerance or the MetS.…”