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2017 ; 8
(ä): 369
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The Effect of Renal Denervation on Plasma Adipokine Profile in Patients with
Treatment Resistant Hypertension
#MMPMID28611687
Eikelis N
; Hering D
; Marusic P
; Duval J
; Hammond LJ
; Walton AS
; Lambert EA
; Esler MD
; Lambert GW
; Schlaich MP
Front Physiol
2017[]; 8
(ä): 369
PMID28611687
show ga
Background: We previously demonstrated the effectiveness of renal denervation
(RDN) to lower blood pressure (BP) at least partially via the reduction of
sympathetic stimulation to the kidney. A number of adipocyte-derived factors are
implicated in BP control in obesity. Aim: The aim of this study was to examine
whether RDN may have salutary effects on the adipokine profile in patients with
resistant hypertension (RH). Methods: Fifty seven patients with RH undergoing RDN
program have been included in this study (65% males, age 60.8 ± 1.5 years, BMI
32.6 ± 0.7 kg/m(2), mean ± SEM). Throughout the study, the patients were on an
average of 4.5 ± 2.7 antihypertensive drugs. Automated seated office BP
measurements and plasma concentrations of leptin, insulin, non-esterified fatty
acids (NEFA), adiponectin and resistin were assessed at baseline and the 3 months
after RDN. Results: There was a significant reduction in mean office systolic
(168.75 ± 2.57 vs. 155.23 ± 3.17 mmHg, p < 0.001) and diastolic (90.68 ± 2.31 vs.
83.74 ± 2.36 mmHg, p < 0.001) BP 3 months after RDN. Body weight, plasma leptin
and resistin levels and heart rate remained unchanged. Fasting insulin
concentration significantly increased 3 months after the procedure (20.05 ± 1.46
vs. 29.70 ± 2.51 uU/ml, p = 0.002). There was a significant drop in circulating
NEFA at follow up (1.01 ± 0.07 vs. 0.47 ± 0.04 mEq/l, p < 0.001). Adiponectin
concentration was significantly higher after RDN (5,654 ± 800 vs. 6,644 ± 967
ng/ml, p = 0.024). Conclusions: This is the first study to demonstrate that RDN
is associated with potentially beneficial effects on aspects of the adipokine
profile. Increased adiponectin and reduced NEFA production may contribute to BP
reduction via an effect on metabolic pathways. Clinical Trial Registration
Number: NCT00483808, NCT00888433.