Rocchini A P
Michigan Congenital Heart Center C.S. Mott Children's Hospital University of Michigan Health Systems, F1310 MCHC, Box 0204, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
Nutr Metab Cardiovasc Dis. 2000 Oct;10(5):287-94.
To review human and animal data describing the complex interrelation between obesity hypertension, salt-sensitivity and insulin resistance.
The first part of the article reviews the information available in the literature defining obesity hypertension as a salt sensitive form of hypertension and that links obesity hypertension to the presence of insulin. The second part reviews the four factors frequently cited as possible causes for this sodium retention: insulin resistance, alteration in the renin-angiotensin system, altered vascular responsiveness and alterations in the sympathetic nervous system. Special emphasis is given in an attempt to explain how each of these four factors can change pressure-natriuresis.
There is clearly a strong relationship between obesity hypertension, sodium sensitivity and insulin resistance. The exact mechanism responsible for linking these three conditions is still unknown. However, there is ample evidence to suggest that insulin resistance, altered vascular responsiveness, altered function of the renin-angiotensin aldosterone system and altered function of the sympathetic nervous system are important in these three conditions. Further investigation is warranted to completely elucidate the complex relationship between insulin resistance, obesity hypertension and sodium sensitivity.
回顾描述肥胖、高血压、盐敏感性和胰岛素抵抗之间复杂相互关系的人类和动物数据。
文章的第一部分回顾了文献中关于将肥胖性高血压定义为一种盐敏感性高血压形式以及将肥胖性高血压与胰岛素存在相联系的现有信息。第二部分回顾了经常被提及的可能导致这种钠潴留的四个因素：胰岛素抵抗、肾素 - 血管紧张素系统改变、血管反应性改变和交感神经系统改变。特别强调试图解释这四个因素中的每一个如何改变压力 - 利钠关系。
肥胖性高血压、钠敏感性和胰岛素抵抗之间显然存在密切关系。连接这三种情况的确切机制仍然未知。然而，有充分证据表明胰岛素抵抗、血管反应性改变、肾素 - 血管紧张素 - 醛固酮系统功能改变和交感神经系统功能改变在这三种情况中很重要。有必要进行进一步研究以完全阐明胰岛素抵抗、肥胖性高血压和钠敏感性之间的复杂关系。
