Elevating circulation chemerin level is associated with endothelial dysfunction and early atherosclerotic changes in essential hypertensive patients

Objectives: Chemerin is a new adipokine elevated in states of obesity and metabolic syndromes. In this study, we investigated the association of increased chemerin on endothelial function, arterial stiffness and early atherosclerosis in essential hypertensive patients. Methods: Three hundred and sixty-seven newly diagnosed essential hypertensive patients were enrolled. Anthropometric measurements and plasma parameters were examined, including BMI, waist circumference, glucose, serum insulin, lipid profiles, chemerin, high-sensitivity C-reactive protein, tumor necrosis factor-alpha, and interleukin-4. Vascular health was assessed with brachial flow-mediated dilatation (FMD), brachial-ankle pulse wave velocity (baPWV), and carotid intima-media thickness (IMT). Results: In hypertensive patients, plasma chemerin levels were higher in women than in men (P < 0.05). In univariate analysis, the plasma chemerin level was positively correlated with baPWV (men: r = 0.58, P r = 0.51, P < 0.01) and carotid IMT (men: r = 0.17, P = 0.01; women: r = 0.20, P = 0.01), and inversely correlated with FMD (men: r = -0.54, P r = -0.44, P < 0.01). The associations for FMD and baPWV, but not IMT, remained significant in multivariable models adjusted for age, sex, glucose homeostasis, lipid profiles, inflammation markers and adipokines. More importantly, logistic regression analysis revealed that high chemerin level was an independent predictor of impaired endothelial function (FMD odds ratio 1.58, 95% confidence interval 1.28-3.30, P = 0.03) and increased arterial stiffness (baPWV odds ratio 3.75, 95% confidence interval 1.36-5.28, P < 0.01), even after adjustment for metabolic variables, inflammatory markers and adipokines. Conclusion: Chemerin levels were independently associated with the index of arterial function and early atherosclerosis in essential hypertension.