腹内压改变对慢性腹水模型大鼠肾素-血管紧张素系统及葡萄糖代谢的影响
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摘要
目的:探讨腹内压力对高血压相关指标肾素、血管紧张素Ⅰ(AngⅠ)、血管紧张素Ⅱ(AngⅡ)和葡萄糖代谢相关指标空腹血糖、糖耐量、胰岛素的影响。方法:将19只大鼠随机分成生理盐水组(对照组)和矿物油组(实验组),实验组腹腔连续间断注射矿物油建立慢性腹水大鼠模型,对照组连续间断注射相同量的生理盐水,5周后测量腹内压,检测肾素、AngⅠ、AngⅡ、胰岛素、空腹血糖水平和糖耐量功能。结果:与对照组相比,实验组肾素与AngⅠ水平明显降低(P<0.05或P<0.01),胰岛素及AngⅡ比较,差异无统计学意义,空腹血糖水平明显降低(P<0.01),葡萄糖激发后的30 min及1 h血糖水平明显升高(P<0.05或P<0.01),2 h血糖水平无显著差异。结论:单独增加腹内压力可能在该动物模型中引起肾素-血管紧张素系统紊乱和葡萄糖代谢异常。
Objective: Overweight and obesity,especially those with abdominal obesity,are more likely to have metabolic diseases.Studies have also shown that pregnant women are more prone to metabolic diseases than non-pregnant women. To investigate the relationship between metabolic diseases and increase in intra-abdominal pressure (IAP),this study investigated the effects of increased IAP on fasting blood glucose,glucose tolerance,and insulin in glucose metabolism and the indicators of hypertension,such as renin,angiotensinⅠ (Ang Ⅰ),angiotensin Ⅱ (Ang Ⅱ). Methods: Nineteen rats were randomly divided into normal saline group and mineral oil group.The experimental group was treated with intermittent intraperitoneal injection of mineral oil to establish a chronic ascites rat model. The control group was continuously injected with the same amount of saline continuously. The intra-abdominal pressure renin,angiotensin Ⅰ,angiotensin Ⅱ,insulin,fasting glucose levels,glucose levels at half an hour and glucose at 1 and 2 hours after glucose challenge were measured after 5 weeks. Results: Compared with the control group,the levels of renin and angiotensin I were significantly lower in the experimental group (P<0.05 or P<0.01). There was no significant difference in insulin and angiotensin II between the two groups,and the fasting blood glucose level was significantly reduced (P<0.01). Glucose levels were significantly increased at half an hour and 1 hour after glucose challenge (P<0.05 or P<0.01),and there was no significant difference in blood glucose level at 2 hours. Conclusion: Increasing intra-abdominal pressure alone may cause renin-angiotensin system disorders and abnormal glucose metabolism in this animal model.
Objective: Overweight and obesity,especially those with abdominal obesity,are more likely to have metabolic diseases.Studies have also shown that pregnant women are more prone to metabolic diseases than non-pregnant women. To investigate the relationship between metabolic diseases and increase in intra-abdominal pressure (IAP),this study investigated the effects of increased IAP on fasting blood glucose,glucose tolerance,and insulin in glucose metabolism and the indicators of hypertension,such as renin,angiotensinⅠ (Ang Ⅰ),angiotensin Ⅱ (Ang Ⅱ). Methods: Nineteen rats were randomly divided into normal saline group and mineral oil group.The experimental group was treated with intermittent intraperitoneal injection of mineral oil to establish a chronic ascites rat model. The control group was continuously injected with the same amount of saline continuously. The intra-abdominal pressure renin,angiotensin Ⅰ,angiotensin Ⅱ,insulin,fasting glucose levels,glucose levels at half an hour and glucose at 1 and 2 hours after glucose challenge were measured after 5 weeks. Results: Compared with the control group,the levels of renin and angiotensin I were significantly lower in the experimental group (P<0.05 or P<0.01). There was no significant difference in insulin and angiotensin II between the two groups,and the fasting blood glucose level was significantly reduced (P<0.01). Glucose levels were significantly increased at half an hour and 1 hour after glucose challenge (P<0.05 or P<0.01),and there was no significant difference in blood glucose level at 2 hours. Conclusion: Increasing intra-abdominal pressure alone may cause renin-angiotensin system disorders and abnormal glucose metabolism in this animal model.
引文
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[2]顾东风,Reynolds K,杨文杰,等.中国成年人代谢综合征的患病率[J].中华糖尿病杂志,2005,13(3):181-186.
[3]Frezza EE,Shebani KO,Robertson J,et al.Morbid obesity causes chronic increase of intraabdominal pressure[J].Dig Dis Sci,2007,52(4):1038-1041.
[4]Sugerman HJ.Effects of increased intra-abdominal pressure in severe obesity[J].Surg Clin North Am,2001,81(5):1063-1075.
[5]Lambert DM,Marceau S,Forse RA.Intra-abdominal pressure in the morbidly obese[J].Obes Surg,2005,15(9):1225-1232.
[6]Varela JE,Hinojosa M,Nguyen N.Correlations between intraabdominal pressure and obesity-related co-morbidities[J].Surg Obes Relat Dis,2009,5(5):524-528.
[7]Yu H,Yang Z,Ding X,et al.Effects of serum from patients with early-onset pre-eclampsia,HELLP syndrome,and antiphospholipid syndrome on fatty acid oxidation in trophoblast cells[J].Arch GynecolObstet,2015,292(3):559-567.
[8]Rafeeinia A,Tabandeh A,Khajeniazi S,et al.Metabolic syndrome in preeclampsia women in gorgan[J].Open Biochem J,2014,8:94-99.
[9]Horvath B,Bodecs T,Boncz I,et al.Metabolic syndrome in normal and complicated pregnancies[J].Metab Syndr Relat Disord,2013,11(3):185-188.
[10]Fuchs F,Bruyere M,Senat MV,et al.Are standard intraabdominal pressure values different during pregnancy[J].PLoSONE,2013,8(10):e77324.
[11]Sawchuck DJ,Wittmann BK.Pre-eclampsia renamed and reframed:Intra-abdominal hypertension in pregnancy[J].Med Hypotheses,2014,83(5):619-632.
[12]Zhang AK.The potential participation of abdominal pressure in preeclampsia[J].Med Hypotheses,2015,84(6):583-585.
[13]Ferron AJT,Jacobsen BB,Sant'Ana PG,et al.Cardiac dysfunction induced by obesity is not related toβ-adrenergic system impairment at the receptor-signalling pathway[J].Plos One,2015,10(9):e0138605.
[14]Pelosi P,Ravagnan I,Giurati G,et al.Positive end-expiratory pressure improves respiratory function in obese but not in normal subjects during anesthesia and paralysis[J].Anesthesiology,1999,91(5):1221-1231.
[15]Pelosi P,Croci M,Ravagnan I,et al.The effects of body mass on lung volumes,respiratory mechanics,and gas exchange during general anesthesia[J].Anesth Analg,1998,87(3):654-660.
[16]Pelosi P,Croci M,Ravagnan I,et al.Respiratory system mechanics in sedated,paralyzed,morbidly obese patients[J].J Appl Physiol,1997,82(3):811-818.
[17]Paolini JB,Mancini J,Genestal M,et al.Predictive value of abdominal obesity vs.body mass index for determining risk of intensive care unit mortality[J].Crit Care Med,2010,38(5):1308-1314.
[18]Sugerman HJ.Hypothesis:Preeclampsia is a venous disease secondary to an increased intra-abdominal pressure[J].Med Hypotheses,2011,77(5):841-849.
[19]Karnak I,Aks9z E,Ekinci S,et al.Increased maternal intraabdominal pressure alters the contractile properties of fetal rabbit bladder[J].J Pediatr Surg,2008,43(9):1711-1717.
[20]Curet MJ,Weber DM,Sae A,et al.Effects of helium pneumoperitoneum in pregnant ewes[J].Surg Endosc,2001,15(7):710-714.
[21]Doty JM,Oda J,Ivatury RR,et al.The effects of hemodynamic shock and increased intra-abdominal pressure on bacterial translocation[J].J Trauma,2002,52(1):13-17.
[22]余剑.腹内高压症对犬心脏、肾上腺、胰腺功能的影响及其机制研究[D].重庆:第三军医大学,2014.
[23]Papavramidis TS,Lazou TP,Cheva A,et al.Chronically increased intra-abdominal pressure:validating a model[J].Obes Surg,2010,20(7):900-905.
[24]Lima RAC,Schanaider A,Santana MCE,et al.Desenvolvimento de um novo modelo experimental desíndrome do compartimento abdominal[J].Rev Col Bras Cir,2011,38(6):417-421.
[25]李生梅,李满桂,贾军,等.腹型肥胖人群、血脂、血管紧张素Ⅱ与高血压病的探讨[J].中国临床医生杂志,2015(10):29-31.
[26]符春晖,严华,陆永光,等.肾素-血管紧张素-醛固酮系统与原发性高血压病的关系[J].现代生物医学进展,2012,12(5):948-950.
[27]王清德.妊娠高血压综合征发病机制的探讨[D].北京:中国协和医科大学,1995.