Serum Adipokines in Hypertensive Male Patients with Metabolic Syndrome and Risk of Left Ventricular Hypertrophy

Background: Adipokines had been suggested for their potential use in tracking the clinical progress in subjects with metabolic syndrome (MS). Retinol binding protein 4 (RBP4), an adipokine, that had been reported to induce insulin resistance and to play a role in the pathogenesis and severity of essential hypertension (EH), while adiponectin was known to have anti-inflammatory and anti-atherogenic activities. Objective : to investigate the relationship between serum RBP4, adiponectin with insulin resistance in hypertensive (HTN) male patients and its role in the severity of hypertension and risk of left ventricular hypertrophy (LVH). Subjects and Methods: This study included twenty five HTN male patients with mean age 48.84 ± 2.59 years and fifteen normal subjects with mean age 50.53 ± 1.96 years as a control (group III).The patients were divided into two groups; Group I, representing HTN patients with MS and Group II representing HTN patients without MS. All included males underwent history taking, physical examination including determination of BMI, waist circumference, blood pressure and the following laboratory investigations: measurement of levels of serum adiponectin, RBP4, lipid profile, uric acid, blood glucose, creatinine, high sensitivity C-reactive protein (hs-CRP) and, insulin together with calculation of homeostasis model assessment-insulin resistance (HOMA-IR).Assays of serum RBP4 and adiponectin were carried out using an enzyme-linked immunosorbent assay (ELISA) technique. Results: patients in Group I were found to have significant higher values of RBP4, BMI, waist circumference, HOMA-IR, uric acids and triglycerides with low adiponectin levels together with high prevalence of LVH compared to patient group II. Serum RBP4 was found to be positively correlated with HOMA-IR, hs-CRP, uric acid, systolic and diastolic blood pressure and negatively correlated with adiponectin and HDL. The area under the ROC curve (AUC) for adiponectin was 0.894 with cut-off value ≤10.75 μg/mL, while the AUC for RBP4 was 0.962 with cut-off value > 101 ng/mL. Conclusion: increased serum RBP4 and HOMA-IR with decreased adiponectin levels have a predictive value for the severity of hypertension and associated risk of LVH in HTN patients with MS.