The Role of Adiponectin, Visfatin and Irisin in the Pathogenesis and Treatment of Arterial Hypertension

Abstract

Background. The pathogenesis of arterial hypertension is not fully understood, although the main mechanisms of blood pressure regulation are generally outlined. An important role in the pathogenesis of hypertension, in addition to the well-known factors, is played by excessive expression of pro-inflammatory cytokines, which are produced by adipose tissue. Aim: to determine the role of adiponectin, visfatin and irisin in the pathogenesis and treatment of arterial hypertension. Materials and methods. 70 patients with arterial hypertension were examined in a randomized manner. Patients were divided into two groups: group 1 - 33 patients with controlled blood pressure and group 2 - 37 people with elevated blood pressure. All study participants underwent a thorough collection of disease and life anamnesis, a general physical examination with measurement of blood pressure (BP), anthropometric measurements with calculation of body mass index (BMI), complete blood count, coagulation test, blood chemistry test, as well as, enzyme-linked immunosorbent assay to determine the level of adiponectin, visfatin, irisin in blood serum and lymphocytes. An echocardiographic examination (EchoCG) was additionally performed. Results. Patients of the first group with normal blood pressure had significantly higher levels of adiponectin (p ˂ 0.01) and irisin (p ˂ 0.05) in blood serum, as well as significantly lower levels of visfatin in blood serum (p ˂ 0.05) compared to the patients of the second group. On the other hand, in lymphocytes, no significant difference was found between the indicators of adiponectin and visfatin between patients of the first and second groups. A positive correlation was found between the level of visfatin in lymphocytes and age (r=0.308; p ˂0.05), fibrinogen (r=0.472; p ˂0.01) and INR (r=0.551; p ˂0.01), as well as significantly positive correlation of visfatin in blood serum and SBP level (r=0.331; p ˂0.05). A positive relationship was established between adiponectin in serum and in lymphocytes and INR (r=0.303; p ˂0.05) and an inverse relationship between serum irisin indicators and the prothrombin index (r=-0.359; p ˂0.05). Conclusion. In patients who achieved the target BP range on the background of low concentrations of total cholesterol and LDL cholesterol, serum visfatin, the content of adiponectin was significantly higher compared with patients of group II, in whom higher BP was worse controlled by antihypertensive drugs. Accordingly, patients who did not reach the target BP range had significantly higher levels of visfatin against a background of significantly lower levels of adiponectin and irisin.