肥胖性高血压患者血清细胞因子与胰岛素敏感性、RAS系统活性的相关性
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摘要
目的:探讨肥胖性高血压患者血清细胞因子与胰岛素敏感性、RAS系统活性的相关性。方法:选择在本院收治的肥胖性高血压患者86例作为肥胖性高血压组,同期在本院体检的健康志愿者50例作为正常对照组。对比两组研究对象血清中脂肪因子、胰岛素敏感性指标、RAS系统指标含量的差异,分析肥胖性高血压患者血清脂肪因子含量与胰岛素敏感性、RAS系统活性的相关性。结果:肥胖性高血压组患者血清中脂肪因子APN的含量低于正常对照组,LEP、Resistin的含量高于正常对照组;外周血中胰岛素敏感性指标HOMA-IR的水平高于正常对照组,ISI的水平低于正常对照组;血清中RAS系统指标PRA、AngⅡ、ALD的含量均显著高于正常对照组。Pearson检验发现,肥胖性高血压患者血清中脂肪因子APN、LEP、Resistin的含量与机体胰岛素敏感性、RAS系统活性直接相关。结论:肥胖性高血压患者血清脂肪因子合成异常,可直接影响机体胰岛素敏感性及RAS系统活性。
Objective:To investigate the correlation of serum cytokines with insulin sensitivity and RAS system activity in patients with obesity-related hypertension.Methods:86 patients with obesity-related hypertension who were treated in this hospital between February 2015 and June 2017 were enrolled in obesity-related hypertension group,and 50 healthy volunteers who received physical examination in this hospital during the same period were enrolled in normal control group.The differences in the levels of serum adipocytokines,insulin sensitivity indexes and RAS system indexes were compared between the two groups of research subjects,and the correlation of serum adipocytokine contents with insulin sensitivity and RAS system activity in patients with obesity-related hypertension was analyzed.Results:Serum adipocytokine APN content of obesity-related hypertension group was lower than that of control group whereas LEP and Resistin contents were higher than those of control group;insulin sensitivity index HOMA-IR level in peripheral blood was higher than that of normal control group whereas ISI level was lower than that of normal control group;RAS system indexes PRA,AngⅡand ALD contents in serum were significantly higher than those of normal control group.Pearson test showed that serum adipocytokines APN,LEP and Resistin contents of patients with obesity-related hypertension were directly correlated with insulin sensitivity and RAS system activity.Conclusion:The abnormal synthesis of serum adipocytokines in patients with obesity-related hypertension can directly affect the insulin sensitivity and RAS system activity.
Objective:To investigate the correlation of serum cytokines with insulin sensitivity and RAS system activity in patients with obesity-related hypertension.Methods:86 patients with obesity-related hypertension who were treated in this hospital between February 2015 and June 2017 were enrolled in obesity-related hypertension group,and 50 healthy volunteers who received physical examination in this hospital during the same period were enrolled in normal control group.The differences in the levels of serum adipocytokines,insulin sensitivity indexes and RAS system indexes were compared between the two groups of research subjects,and the correlation of serum adipocytokine contents with insulin sensitivity and RAS system activity in patients with obesity-related hypertension was analyzed.Results:Serum adipocytokine APN content of obesity-related hypertension group was lower than that of control group whereas LEP and Resistin contents were higher than those of control group;insulin sensitivity index HOMA-IR level in peripheral blood was higher than that of normal control group whereas ISI level was lower than that of normal control group;RAS system indexes PRA,AngⅡand ALD contents in serum were significantly higher than those of normal control group.Pearson test showed that serum adipocytokines APN,LEP and Resistin contents of patients with obesity-related hypertension were directly correlated with insulin sensitivity and RAS system activity.Conclusion:The abnormal synthesis of serum adipocytokines in patients with obesity-related hypertension can directly affect the insulin sensitivity and RAS system activity.
引文
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19 Schütten MT,Houben AJ,de Leeuw PW,et al.The Link Between Adipose Tissue Renin-Angiotensin-Aldosterone System Signaling and Obesity-Associated Hypertension[J].Physiology(Bethesda),2017,32(3):197-209.
2 Sugai T,Suzuki Y,Yamazaki M,et al.High Prevalence of Obesity,Hypertension,Hyperlipidemia,and Diabetes Mellitus in Japanese Outpatients with Schizophrenia:A Nationwide Survey[J].PLoS One,2016,11(11):e0166429.
3 de Mendon9a L,Felix NS,Blanco NG,et al.Mesenchymal stromal cell therapy reduces lung inflammation and vascular remodeling and improves hemodynamics in experimental pulmonary arterial hypertension[J].Stem Cell Res Ther,2017,8(1):220.
4 Simplicio JA,Gonzaga NA,Nakashima MA,et al.Tumor necrosis factor-αreceptor 1contributes to ethanol-induced vascular reactive oxygen species generation and hypertension[J].J Am Soc Hypertens,2017,11(10):684-696.
5 Luo L,Zheng W,Lian G,et al.Combination treatment of adipose-derived stem cells and adiponectin attenuates pulmonary arterial hypertension in rats by inhibiting pulmonary arterial smooth muscle cell proliferation and regulating the AMPK/BMP/Smad pathway[J].Int J Mol Med,2018,41(1):51-60.
6 Xu Q,Fan D,Li F,et al.Influence of serum HMW adiponectin level in patients with pregnancy-induced hypertension syndrome on the occurrence of eclampsia in secondary pregnancy[J].Exp Ther Med,2017,14(5):4972-4976.
7 Tonelli AR,Fares WH,Dakkak W,et al.Do single or sequential measurements of leptin and adiponectin in plasma have prognostic value in pulmonary arterial hypertension?[J].Pulm Circ,2017,7(3):727-729.
8 Yu B,Cai D.Neural Programmatic Role of Leptin,TNFα,Melanocortin,and Glutamate in Blood Pressure Regulation vs Obesity-Related Hypertension in Male C57BL/6 Mice[J].Endocrinology,2017,158(6):1766-1775.
9 Zhang Y,Li Y,Yu L,et al.Association between serum resistin concentration and hypertension:A systematic review and meta-analysis[J].Oncotarget,2017,8(25):41529-41537.
10 Zhang M,Cui H,Zhu BP,et al.Association of serum resistin with cystatin C and urinary albumin-to-creatinine ratio in elderly Chinese men with essential hypertension[J].Postgrad Med J,2015,91(1073):132-137.
11 Szulinska M,Gibas-Dorna M,Miller-Kasprzak E,et al.Spirulina maxima improves insulin sensitivity,lipid profile,and total antioxidant status in obese patients with well-treated hypertension:a randomized double-blind placebo-controlled study[J].Eur Rev Med Pharmacol Sci,2017,21(10):2473-2481.
12 Fizelova M,Jauhiainen R,StanˇcákováA,et al.Finnish Diabetes Risk Score Is Associated with Impaired Insulin Secretion and Insulin Sensitivity,Drug-Treated Hypertension and Cardiovascular Disease:A Follow-Up Study of the METSIM Cohort[J].PLoS One,2016,11(11):e0166584.
13 Jordan J,Stinkens R,Jax T,et al.Improved Insulin Sensitivity With Angiotensin Receptor Neprilysin Inhibition in Individuals With Obesity and Hypertension[J].Clin Pharmacol Ther,2017,101(2):254-263.
14 Skrn SN,Flaa A,Kjeldsen SE,et al.Family history of hypertension and serum triglycerides predict future insulin sensitivity:a 17-year follow-up study of young men[J].J Hypertens,2015,33(9):1845-1851
15 Han W,Sun N,Chen L,et al.Relationship of renin-angiotensin system polymorphisms with ambulatory and central blood pressure in patients with hypertension[J].J Clin Hypertens(Greenwich),2017,19(11):1081-1087.
16 Walton SL,Bielefeldt-Ohmann H,Singh RR,et al.Prenatal hypoxia leads to hypertension,renal renin-angiotensin system activation and exacerbates salt-induced pathology in a sex-specific manner[J].Sci Rep,2017,7(1):8241.
17 Wang J,Lu W,Li J,et al.Hemodynamic effects of renin-angiotensin-aldosterone inhibitor andβ-blocker combination therapy vs.β-blocker monotherapy for portal hypertension in cirrhosis:A meta-analysis[J].Exp Ther Med,2017,13(5):1977-1985.
18 Ji LD,Li JY,Yao BB,et al.Are genetic polymorphisms in the renin-angiotensin-aldosterone system associated with essential hypertension?Evidence from genome-wide association studies[J].J Hum Hypertens,2017,31(11):695-698.
19 Schütten MT,Houben AJ,de Leeuw PW,et al.The Link Between Adipose Tissue Renin-Angiotensin-Aldosterone System Signaling and Obesity-Associated Hypertension[J].Physiology(Bethesda),2017,32(3):197-209.