Endocrinol Metab.  2020 Jun;35(2):351-358. 10.3803/EnM.2020.35.2.351.

Apolipoprotein B Levels Predict Future Development of Hypertension Independent of Visceral Adiposity and Insulin Sensitivity

Affiliations
  • 1Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
  • 2Department of Medicine, University of Washington School of Medicine, USA
  • 3Hospital and Specialty Medicine Service, VA Puget Sound Health Care System, USA
  • 4Department of Anthropology, University of Washington, USA
  • 5Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA

Abstract

Background
High plasma apolipoprotein B (apoB) levels have been shown to be associated with hypertension, central obesity, and insulin resistance in cross-sectional research. However, it is unclear whether apoB levels predict future hypertension independent of body composition and insulin sensitivity. Therefore, we prospectively investigated whether plasma apoB concentrations independently predicted the risk of hypertension in a cohort of Japanese Americans.
Methods
A total of 233 normotensive Japanese Americans (77 men, 156 women; mean age, 46.4±11.0 years) were followed over 10 years to monitor them for the development of hypertension. Fasting plasma concentrations of apoB, glucose, and insulin were measured at baseline. Insulin sensitivity was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR). The abdominal visceral and subcutaneous fat areas were measured at baseline using computed tomography. Logistic regression analysis was used to estimate the association between apoB concentrations and the odds of incident hypertension.
Results
The 10-year cumulative incidence of hypertension was 21.5%. The baseline apoB level was found to be positively associated with the odds of incident hypertension over 10 years after adjustment for age, sex, body mass index, systolic blood pressure, abdominal visceral fat area, abdominal subcutaneous fat area, total plasma cholesterol concentration, diabetes status, and HOMA-IR at baseline (odds ratio and 95% confidence interval for a 1-standard deviation increase, 1.89 [1.06 to 3.37]; P=0.030).
Conclusion
Higher apoB concentrations predicted greater risks of future hypertension independent of abdominal visceral fat area and insulin sensitivity in Japanese Americans.

Keyword

Apolipoproteins B; Hypertension; Intra-abdominal fat; Epidemiology; Prospective studies

Reference

1. Ferdinand KC, Kleinpeter MA. Management of hypertension and dyslipidemia. Curr Hypertens Rep. 2006; 8:489–96.
Article
2. Bønaa KH, Thelle DS. Association between blood pressure and serum lipids in a population. The Tromso Study. Circulation. 1991; 83:1305–14.
3. Cicero AF, D’Addato S, Veronesi M, Rosticci M, Santi F, Dormi A, et al. Relationship between blood pressure, cholesterolemia and serum apolipoprotein B in a large population sample: the Brisighella Heart Study. J Hypertens. 2012; 30:492–6.
4. Borghi C, Rodriguez-Artalejo F, De Backer G, Dallongeville J, Medina J, Guallar E, et al. The association between blood pressure and lipid levels in Europe: European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice. J Hypertens. 2016; 34:2155–63.
5. Boyko EJ, Doheny RA, McNeely MJ, Kahn SE, Leonetti DL, Fujimoto WY. Latent class analysis of the metabolic syndrome. Diabetes Res Clin Pract. 2010; 89:88–93.
Article
6. Carr DB, Utzschneider KM, Hull RL, Kodama K, Retzlaff BM, Brunzell JD, et al. Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. Diabetes. 2004; 53:2087–94.
Article
7. Ginsberg HN, Zhang YL, Hernandez-Ono A. Metabolic syndrome: focus on dyslipidemia. Obesity (Silver Spring). 2006; 14(Suppl 1):41S–9S.
Article
8. Morita SY. Metabolism and modification of apolipoprotein B-containing lipoproteins involved in dyslipidemia and atherosclerosis. Biol Pharm Bull. 2016; 39:1–24.
Article
9. Sniderman AD, Williams K, Contois JH, Monroe HM, McQueen MJ, de Graaf J, et al. A meta-analysis of low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B as markers of cardiovascular risk. Circ Cardiovasc Qual Outcomes. 2011; 4:337–45.
Article
10. Pedersen TR, Olsson AG, Faergeman O, Kjekshus J, Wedel H, Berg K, et al. Lipoprotein changes and reduction in the incidence of major coronary heart disease events in the Scandinavian Simvastatin Survival Study (4S). Circulation. 1998; 97:1453–60.
Article
11. Simes RJ, Marschner IC, Hunt D, Colquhoun D, Sullivan D, Stewart RA, et al. Relationship between lipid levels and clinical outcomes in the Long-term Intervention with Pravastatin in Ischemic Disease (LIPID) Trial: to what extent is the reduction in coronary events with pravastatin explained by on-study lipid levels? Circulation. 2002; 105:1162–9.
Article
12. Okosun IS, Choi S, Hash R, Dever GE. Apolipoprotein B, ratio of total cholesterol to HDL-C, and blood pressure in abdominally obese white and black American women. J Hum Hypertens. 2001; 15:299–305.
Article
13. Onat A, Can G, Hergenc G, Yazici M, Karabulut A, Albayrak S. Serum apolipoprotein B predicts dyslipidemia, metabolic syndrome and, in women, hypertension and diabetes, independent of markers of central obesity and inflammation. Int J Obes (Lond). 2007; 31:1119–25.
Article
14. Laaksonen DE, Niskanen L, Nyyssonen K, Lakka TA, Laukkanen JA, Salonen JT. Dyslipidaemia as a predictor of hypertension in middle-aged men. Eur Heart J. 2008; 29:2561–8.
Article
15. Paynter NP, Sesso HD, Conen D, Otvos JD, Mora S. Lipoprotein subclass abnormalities and incident hypertension in initially healthy women. Clin Chem. 2011; 57:1178–87.
Article
16. Koskinen J, Magnussen CG, Wurtz P, Soininen P, Kangas AJ, Viikari JS, et al. Apolipoprotein B, oxidized low-density lipoprotein, and LDL particle size in predicting the incidence of metabolic syndrome: the Cardiovascular Risk in Young Finns study. Eur J Prev Cardiol. 2012; 19:1296–303.
Article
17. Despres JP, Lamarche B. Effects of diet and physical activity on adiposity and body fat distribution: implications for the prevention of cardiovascular disease. Nutr Res Rev. 1993; 6:137–59.
18. Hayashi T, Boyko EJ, Leonetti DL, McNeely MJ, Newell-Morris L, Kahn SE, et al. Visceral adiposity and the prevalence of hypertension in Japanese Americans. Circulation. 2003; 108:1718–23.
Article
19. Hayashi T, Boyko EJ, Leonetti DL, McNeely MJ, Newell-Morris L, Kahn SE, et al. Visceral adiposity is an independent predictor of incident hypertension in Japanese Americans. Ann Intern Med. 2004; 140:992–1000.
Article
20. Sullivan CA, Kahn SE, Fujimoto WY, Hayashi T, Leonetti DL, Boyko EJ. Change in intra-abdominal fat predicts the risk of hypertension in Japanese Americans. Hypertension. 2015; 66:134–40.
Article
21. Fujimoto WY, Leonetti DL, Kinyoun JL, Shuman WP, Stolov WC, Wahl PW. Prevalence of complications among second-generation Japanese-American men with diabetes, impaired glucose tolerance, or normal glucose tolerance. Diabetes. 1987; 36:730–9.
Article
22. Koppes LL, Dekker JM, Hendriks HF, Bouter LM, Heine RJ. Moderate alcohol consumption lowers the risk of type 2 diabetes: a meta-analysis of prospective observational studies. Diabetes Care. 2005; 28:719–25.
Article
23. Paffenbarger RS Jr, Wing AL, Hyde RT. Physical activity as an index of heart attack risk in college alumni. Am J Epidemiol. 1978; 108:161–75.
Article
24. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2004; 27(Suppl 1):S5–10.
25. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28:412–9.
26. Shuman WP, Morris LL, Leonetti DL, Wahl PW, Moceri VM, Moss AA, et al. Abnormal body fat distribution detected by computed tomography in diabetic men. Invest Radiol. 1986; 21:483–7.
Article
27. Janssen I, Heymsfield SB, Allison DB, Kotler DP, Ross R. Body mass index and waist circumference independently contribute to the prediction of nonabdominal, abdominal subcutaneous, and visceral fat. Am J Clin Nutr. 2002; 75:683–8.
Article
28. Riches FM, Watts GF, Naoumova RP, Kelly JM, Croft KD, Thompson GR. Hepatic secretion of very-low-density lipoprotein apolipoprotein B-100 studied with a stable isotope technique in men with visceral obesity. Int J Obes Relat Metab Disord. 1998; 22:414–23.
Article
29. Feingold KR, Anawalt B, Boyce A. Endotext. Dartmouth: MDText.com Inc;2000. Chapter, The role of lipids and lipoproteins in atherosclerosis. Available from: https://www.ncbi.nlm.nih.gov/books/NBK343489/.
30. Rasmussen JG, Eschen RB, Aardestrup IV, Dethlefsen C, Griffin BA, Schmidt EB. Flow-mediated vasodilatation: variation and interrelationships with plasma lipids and lipoproteins. Scand J Clin Lab Invest. 2009; 69:156–60.
Article
31. Skalen K, Gustafsson M, Rydberg EK, Hulten LM, Wiklund O, Innerarity TL, et al. Subendothelial retention of atherogenic lipoproteins in early atherosclerosis. Nature. 2002; 417:750–4.
Article
32. Oparil S, Zaman MA, Calhoun DA. Pathogenesis of hypertension. Ann Intern Med. 2003; 139:761–76.
Article
33. Faraj M, Messier L, Bastard JP, Tardif A, Godbout A, Prud’homme D, et al. Apolipoprotein B: a predictor of inflammatory status in postmenopausal overweight and obese women. Diabetologia. 2006; 49:1637–46.
Article
34. De Miguel C, Rudemiller NP, Abais JM, Mattson DL. Inflammation and hypertension: new understandings and potential therapeutic targets. Curr Hypertens Rep. 2015; 17:507.
Article
35. Chan DC, Watts GF. Apolipoproteins as markers and managers of coronary risk. QJM. 2006; 99:277–87.
Article
36. Muntner P, Shimbo D, Carey RM, Charleston JB, Gaillard T, Misra S, et al. Measurement of blood pressure in humans: a scientific statement from the American Heart Association. Hypertension. 2019; 73:e35–66.
Article
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