Co-effect of insulin resistance and biomarkers of inflammation and endothelial dysfunction on hypertension.

To explore the co-effects of inflammation and endothelial dysfunction and insulin resistance (IR) on hypertension in a large Asian population. Data on demographic characteristics, blood pressure and other variables were collected; additionally, fasting plasma glucose, insulin and biomarkers, including C-reactive protein (CRP), soluble intercellular cell adhesion molecule-1 (sICAM-1), soluble E-selectin (sE-selectin) and angiotensin II were examined among 2553 Mongolian adults aged ≥ 20 years. IR was assessed using the homeostasis model. The co-effects of elevated biomarkers of inflammation and endothelial dysfunction and IR on hypertension were analyzed. A total of 953 subjects were diagnosed with hypertension. Among hypertensive subjects, the levels of CRP (11.0 vs. 6.7 mg l(-1)), sICAM-1 (348.3 vs. 335.9 ng ml(-1)), sE-selectin (20.9 vs. 18.5 ng ml(-1)) and angiotensin II (61.3 vs. 50.0 pg ml(-1)) were significantly higher among subjects with IR than those without IR; among normotensives, levels of CRP (6.3 vs. 5.2 mg l(-1)) and sE-selectin (20.1 vs. 17.8 ng ml(-1)) were higher among IR subjects than those without IR. The prevalence of hypertension was significantly higher among subjects with IR and 2 elevated biomarkers (69.0%) and those with IR and ≥ 3 elevated biomarkers (79.3%) than among those with IR and no elevated biomarkers (45.9%) and those with IR and 1 elevated biomarker (50.6%). After adjusting for multivariate, the risk of hypertension was significantly associated with the coexistence of IR and any two or three elevated biomarkers (odds ratios (OR) (95% confidence intervals (CIs)) = 2.55 (1.60-4.06) and 3.19 (1.15-8.86), respectively). In this Mongolian population, IR and elevated biomarkers of inflammation and endothelial dysfunction were related to hypertension and the coexistence of IR and elevated biomarkers of inflammation and endothelial dysfunction increased the risk of hypertension.