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Esansiyel Hipertansif Hastalarda Serum Leptin Seviyesi ve Endotel Fonksiyonu Arasındaki İlişki

Relation Between Endothelial Function and Leptin Level in Essential Hypertensive Patients

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2006

Key Words:

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Insulin resistance and sympathetic activation are shown to play a role in the pathogenesis of essential hypertension. The ro¬ le of sympathetic activation in essential hypertension has been documented by a variety of tecniques. It has been known that leptin, produced by mainly adipose tissue, play a role in the pathogenesis of hypertension by causing sympathetic activation. Besi¬ des that, leptin may cause oxidative stress in endothelial cells by inducing free oxygen radicals. Both oxidative stress and sympat¬ hetic activation may be a cause of endothelial dysfunction, desc¬ ribed as an impairment of endothelium-dependent vasodilatation, seen also in essential hypertensive patients. In v i ew of these data, in this study we aimed to investigate a relation between endothelium- dependent dilatation and leptin in patients with essential hypertension. Thirty-five patients with essential hypertension (age: 44.2±7.1, male/female: 19/16) and age and gender matched 38 healty controls (age:44.8 ± 5.6, male/female:20/18) were included in this study. The measurements of endothelial function were done by ultrasonography described by Celermajer et al. Serum leptin levels d id not differ significantly between the two groups (3.86±4.4, 3.01±3.2 p>0. 05). Flow and nitrate mediated dilatation were found to be reduced in hypertensive group when compared to control group. Flow mediated dilatation: 5.2±3.2 vs 12.7±3.6, p<0.001; nitrate mediated dilatation: 17.2±5.8 vs 22.4±5.5, p<0.001. Although there were positive relation of leptin with body mass index and adipose tissuemass (respectively; r=0.47 ve r=0.50, p<0.01), there were no relation between leptin and flow and nitrate mediated dilatation (r=-0.042 r=-0.038, p>0.05). As a conclusions; essential hypertensive patients were characterized by endothelial dysfunction. In additon, there was no relation between leptin and endothelial function in essential hypertensive patients.
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Abstract (Original Language): 
Insulin direnci ve sempatik aktivasyon esansiyel hipertansiyon patogenezinde rol oynamaktadır. Esansiyel hipertansif hastalarda sempatik aktivasyon varlığı farklı yöntemlerle gösterilmiştir. Başlıca yağ dokusunda sentezlenen leptinin de sempatik aktivasyona yol açarak esansiyel hipertansiyon patogenezinde rol oynadığı bilinmektedir. Ayrıca leptin, endotel hücrelerinden serbest oksijen radikali oluşturarak oksidatif stres oluşumuna neden olabilmektedir. Hem oksidatif stres hem de sempatik aktivasyon endotele bağlı dilatasyonun bozulması olarak tanımlanan ve esansiyel hipertansi¬ yon hastalarında görülen endotel disfonksiyonuna yol açabilmekte¬ dir. Bu bilgilerin ışığında, bu çalışmada, esansiyel hipertansif hastalarda serum leptin seviyesi ile endotel fonksiyonu arasındaki ilişkinin araştırılması amaçlanmıştır. Çalışmaya 35 esansiyel hipertansiyon hastası (yaş: 44.2±7.1, erkek/kadın: 19/16) ve demografik özellikleri benzer 38 sağlıklı kontrol (yaş: 44.8±5.6, erkek/kadın: 20/18) dahil edildi. Hastaların endotel fonksiyonları daha önce Celermajer ve arkadaşlarının tarif ettiği şekilde ultrasonografik ölçümle değerlendirildi. Serum leptin seviyesi hasta ve sağlıklı kontrol grubunda karşılaştırıldığında her iki grup arasında fark bulunmamaktaydı (3.86±4.4, 3.01±3.2 p>0.05). Endotel fonksiyonunun göstergesi olan akıma bağlı dilatasyon, hipertansif grupta kontrol grubu ile karşılaştırıldığında istatistiksel olarak anlamlı derecede azalmış bulundu (%5.2±3.2'ye karşı %12.7±3.6 p<0.001).Aynı zamanda hipertansif hasta grubunda nitrata bağlı dilatasyon da sağlıklı kontrol grubu ile karşılaştırıldığında istatistiksel olarak anlamlı derecede düşük saptandı (%17.2±5.8'ye karşı %22.4±5.5 p<0.001). Leptinin vücut kitle indeksi VKİ (kg/m2), yağ miktarı (kg) ile istatistiksel olarak anlamlı pozitif bir ilişkisi bulunmasına rağmen (sırasıyla; r=0.47 ve r=0.50, p<0.01), akıma bağlı dilatasyonla ve nitrata bağlı dilatasyonla ilişkisi bulunmamaktaydı (sırasıyla r=- 0.042 ve r=-0.038, p>0.05). Sonuç olarak, esansiyel hipertansif hastalar endotel disfonksi-yonuyla karakterize olup, serum leptin seviyesi ile endotel fonksi¬yonu seviyesi arasında ilişki bulunmamaktadır.
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  • 4
207-212
  • Turkish

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