Pediatric Cardiology

, Volume 38, Issue 8, pp 1639–1644 | Cite as

Serum Resistin Negatively Correlates with Clinical Severity of Postural Tachycardia Syndrome in Children

  • Wei Bai
  • Zhenhui Han
  • Siyao Chen
  • Hongxia Li
  • Jingyuan Song
  • Jianguang Qi
  • Ying Liao
  • Chaoshu Tang
  • Ping Liu
  • Yuli Wang
  • Hongfang JinEmail author
  • Junbao Du
Original Article


This study was designed to analyse the serum resistin level in children with postural tachycardia syndrome (POTS) and its clinical significance. Twenty-one children with POTS and 31 healthy children as controls participated in the study. Clinical characteristics, heart rate and blood pressure in the supine and upright positions were monitored and collected during an upright test, and the symptom scoring of POTS patients was recorded. The serum resistin levels of patients in both groups were determined by enzyme-linked immunosorbent assay. The change in serum resistin levels in the POTS group before and after standing, as well as its correlation with symptom scores and change in heart rate after standing, was analysed. Compared with the control group, the serum resistin levels in the POTS group were significantly increased (P < 0.01). The serum resistin levels in the POTS group before and after standing did not differ (P > 0.05). There was a negative correlation between the serum resistin levels and a change in heart rate from the supine to upright position (correlation coefficient = −0.615, P < 0.01). Moreover, serum resistin levels were negatively correlated with symptom scores (correlation coefficient = −0.493, P < 0.05). Serum resistin levels in children with POTS were significantly higher than those in healthy children and negatively correlated with a change in heart rate from the supine to upright position and symptom scores. These results suggest a protective role of increased resistin in the pathogenesis of POTS.


Postural tachycardia syndrome (POTS) Resistin Children 


Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all participants in this study in the form of written consent from parents and written assent from children.

Supplementary material

246_2017_1708_MOESM1_ESM.pdf (197 kb)
Supplementary material 1 (PDF 196 kb)


  1. 1.
    Lin J, Han Z, Li X, Ochs T, Zhao J, Zhang X et al (2014) Risk factors for postural tachycardia syndrome in children and adolescents. PLoS ONE 9:e113625–e113625CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Fu Q, VanGundy TB, Galbreath MM, Shibata S, Jain M, Hastings JL et al (2010) Cardiac origins of the postural orthostatic tachycardia syndrome. J Am Coll Cardiol 55:2858–2868CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Elsayed H (1996) Salt supplement increases plasma volume and orthostatic tolerance in patients with unexplained syncope. Heart 75:134–140CrossRefGoogle Scholar
  4. 4.
    Low PA, Opfer-Gehrking TL, Textor SC, Benarroch EE, Shen WK (2009) Postural tachycardia syndrome (POTS). J Cardiovasc Electrophysiol 20:352–358CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Zhang Q, Liao Y, Tang C, Du J, Jin H (2012) Twenty-four-hour urinary sodium excretion and postural orthostatic tachycardia syndrome. J Pediatr 161:281–284CrossRefPubMedGoogle Scholar
  6. 6.
    Jordan J, Shannon JR, Diedrich A, Black BK, Robertson D (2002) Increased sympathetic activation in idiopathic orthostatic intolerance: role of systemic adrenoreceptor sensitivity. Hypertension 39:173–178CrossRefPubMedGoogle Scholar
  7. 7.
    Zhang Q, Xia C, Li J, Du J (2014) Orthostatic plasma norepinephrine level as a predictor for therapeutic response to metoprolol in children with postural tachycardia syndrome. J Translat Med 12:1–6CrossRefGoogle Scholar
  8. 8.
    Wang XL, Chai Q, Charlesworth MC, Figueroa JJ, Low P, Shen WK et al (2012) Autoimmunoreactive IgGs from patients with postural orthostatic tachycardia syndrome. Proteom Clin Appl 6:615–625CrossRefGoogle Scholar
  9. 9.
    Yu X, Stavrakis S, Hill MA, Huang S, Reim S, Li H et al (2012) Autoantibody activation of beta-adrenergic and muscarinic receptors contributes to an “autoimmune” orthostatic hypotension. J Am Soc Hypertens 6:40–47CrossRefPubMedGoogle Scholar
  10. 10.
    Wang XL, Ling TY, Charlesworth MC, Figueroa JJ, Low P, Shen WK et al (2013) Autoimmunoreactive IgGs against cardiac lipid raft-associated proteins in patients with postural orthostatic tachycardia syndrome. Trans Res 162:34–44CrossRefGoogle Scholar
  11. 11.
    Thieben MJ, Sandroni P, Sletten DM, Benrud-Larson LM, Fealey RD, Vernino S et al (2007) Postural orthostatic tachycardia syndrome: the Mayo clinic experience. Mayo Clin Proc 82:308–313CrossRefPubMedGoogle Scholar
  12. 12.
    Liao Y, Chen S, Liu X, Zhang Q, Ai Y, Wang Y et al (2010) Flow-Mediated vasodilation and endothelium function in children with postural orthostatic tachycardia syndrome. Am J Cardiol 106:378–382CrossRefPubMedGoogle Scholar
  13. 13.
    Zhang F, Li X, Ochs T, Chen L, Liao Y, Tang C et al (2012) Midregional pro-adrenomedullin as a predictor for therapeutic response to midodrine hydrochloride in children with postural orthostatic tachycardia syndrome. J Am Coll Cardiol 60:315–320CrossRefPubMedGoogle Scholar
  14. 14.
    Zhang F, Li X, Chen S, Chen L, Liao Y, Tang C et al (2012) Plasma hydrogen sulfide in differential diagnosis between vasovagal syncope and postural orthostatic tachycardia syndrome in children. J Pediatr 160:227–231CrossRefPubMedGoogle Scholar
  15. 15.
    Medow MS, Minson CT, Stewart JM (2005) Decreased microvascular nitric oxide–dependent vasodilation in postural tachycardia syndrome. Circulation 112:2611–2618CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Steppan CM, Bailey ST, Bhat S, Brown EJ et al (2001) The hormone resistin links obesity to diabetes. Nature 409:307–312CrossRefPubMedGoogle Scholar
  17. 17.
    Jamaluddin MS, Weakley SM, Yao Q, Chen C (2012) Resistin: functional roles and therapeutic considerations for cardiovascular disease. Br J Pharmacol 165:622–632CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Hs J, Kh P, Ym C, Ss C, Hj C, Sy C et al (2006) Resistin is secreted from macrophages in atheromas and promotes atherosclerosis. Cardiovasc Res 69:76–85CrossRefGoogle Scholar
  19. 19.
    Norata GD, Ongari M, Garlaschelli K, Raselli S, Grigore L, Catapano AL (2007) Plasma resistin levels correlate with determinants of the metabolic syndrome. Eur J Endocrinol 156:279CrossRefPubMedGoogle Scholar
  20. 20.
    Gamboa A, Okamoto LE, Raj SR, Diedrich A, Shibao CA, Robertson D et al (2013) Nitric oxide and regulation of heart rate in patients with postural tachycardia syndrome and healthy subjects. Hypertension 61:376–381CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Yang J, Zhao J, Du S, Liu D, Fu C, Li X et al (2013) Postural orthostatic tachycardia syndrome with increased erythrocytic hydrogen sulfide and response to midodrine hydrochloride. J Pediatr 163(1169–1173):e1162Google Scholar
  22. 22.
    Reilly MP, Lehrke M, Wolfe ML, Rohatgi A, Lazar MA, Rader DJ (2005) Resistin is an inflammatory marker of atherosclerosis in humans. Circulation 111:932–939CrossRefPubMedGoogle Scholar
  23. 23.
    Bokarewa M, Nagaev I, Dahlberg L, Smith U, Tarkowski A (2005) Resistin, an adipokine with potent proinflammatory properties. J Immunol 174:5789–5795CrossRefPubMedGoogle Scholar
  24. 24.
    Calabro P, Samudio I, Willerson JT, Yeh ET (2004) Resistin promotes smooth muscle cell proliferation through activation of extracellular signal-regulated kinase 1/2 and phosphatidylinositol 3-kinase pathways. Circulation 110:3335–3340CrossRefPubMedGoogle Scholar
  25. 25.
    Verma S, Li SH, Wang CH, Fedak PW, Li RK, Weisel RD et al (2003) Resistin promotes endothelial cell activation: further evidence of adipokine-endothelial interaction. Circulation 108:736–740CrossRefPubMedGoogle Scholar
  26. 26.
    Kawanami D, Maemura K, Takeda N, Harada T, Nojiri T, Imai Y et al (2004) Direct reciprocal effects of resistin and adiponectin on vascular endothelial cells: a new insight into adipocytokine–endothelial cell interactions. Biochem Biophys Res Commun 314:415–419CrossRefPubMedGoogle Scholar
  27. 27.
    Sun Y, Tang CS, Jb DU, Jin HF (2011) Hydrogen sulfide and vascular relaxation. Chin Med J (Engl). 124:3816–3819PubMedGoogle Scholar
  28. 28.
    Li H, Liao Y, Han Z, Wang Y, Liu P, Zhang Q et al (2015) Changes of plasma intermedin during head-up tilt test in children with postural tachycardia syndrome and its significance. Zhonghua Er Ke Za Zhi 53:375–378PubMedGoogle Scholar
  29. 29.
    Fang C, Lei J, Zhou SX, Zhang YL, Yuan GY, Wang JF (2013) Association of higher resistin levels with inflammatory activation and endothelial dysfunction in patients with essential hypertension. Zhonghua Er Ke Za Zhi 126:646–649Google Scholar
  30. 30.
    Takata Y, Osawa H, Kurata M, Kurokawa M, Yamauchi J, Ochi M et al (2008) Hyperresistinemia is associated with coexistence of hypertension and type 2 diabetes. Hypertension 51:534–539CrossRefPubMedGoogle Scholar
  31. 31.
    Zhang L, Curhan GC, Forman JP (2010) Plasma resistin levels associate with risk for hypertension among nondiabetic women. J Am Soc Nephrol 21:1185–1191CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Wei Bai
    • 1
  • Zhenhui Han
    • 2
  • Siyao Chen
    • 3
  • Hongxia Li
    • 1
  • Jingyuan Song
    • 1
  • Jianguang Qi
    • 1
  • Ying Liao
    • 1
  • Chaoshu Tang
    • 4
    • 5
  • Ping Liu
    • 1
  • Yuli Wang
    • 1
  • Hongfang Jin
    • 1
    Email author
  • Junbao Du
    • 1
  1. 1.Department of PediatricsPeking University First HospitalBeijingPeople’s Republic of China
  2. 2.Department of Medical and Educational AdministrationChildren’s Hospital of KaifengKaifengPeople’s Republic of China
  3. 3.Department of the Intensive Care Unit of Cardiac Surgery, Guangdong Cardiovascular InstituteGuangdong General Hospital and Guangdong Academy of Medical SciencesGuangzhouPeople’s Republic of China
  4. 4.Department of Physiology and PathophysiologyPeking University Health Science CenterBeijingPeople’s Republic of China
  5. 5.Key Laboratory of Molecular CardiologyMinistry of EducationBeijingPeople’s Republic of China

Personalised recommendations