肥胖合并动脉高血压患者中肾上腺髓质素和内皮素-1的循环水平升高

[High circulating levels of adrenomedullin and endothelin-1 in obesity associated with arterial hypertension].

作者信息

Letizia C, Celi M, Cerci S, Scuro L, Delfini E, Subioli S, Caliumi C, D'Erasmo E

机构信息

Cattedra di Medicina Interna Dipartimento di Scienze Cliniche Università degli Studi La Sapienza Policlinico Umberto I Viale del Policlinico, 155 00161 Roma.

出版信息

Ital Heart J Suppl. 2001 Sep;2(9):1011-5.

PMID:11675821

Abstract

BACKGROUND

The aim of the study was to investigate the behavior of two endothelial vasoactive peptides, adrenomedullin (vasodilator) and endothelin-1 (vasoconstrictor), in human obesity with and without arterial hypertension.

METHODS

The study was carried out on 30 obese subjects (body mass index > 27 kg/m2) divided into two groups: 15 normotensive obese patients (10 males, 5 females, mean age 42 +/- 12 years) and 15 hypertensive obese patients (9 males, 6 females, mean age 42 +/- 13 years). The control group consisted of 21 normal subjects (12 males, 9 females, mean age 38 +/- 12 years) and of 16 patients with essential hypertension (10 males, 6 females, mean age 41 +/- 12 years) but without organ damage. All studied subjects were taking a normocaloric (20-22 kcal/kg/day), normosodic (120-140 mEq/day) and normopotassic (50-60 mEq/day) diet. Between 8.00 and 9.00 a.m., a venous blood sample was taken for the determination (radioimmunoassay) of plasma adrenomedullin and endothelin-1 concentrations.

RESULTS

Plasma adrenomedullin levels in normal subjects (13.7 +/- 6.1 pg/ml) were similar to those in normotensive obese patients (14.8 +/- 7.2 pg/ml), whereas in hypertensive obese patients (22.5 +/- 9.1 pg/ml) and in those with essential hypertension (22.7 +/- 8.2 pg/ml) levels were significantly higher (ANOVA = 0.000, p < 0.05) than those of normal subjects and of normotensive obese patients. Moreover, endothelin-1 plasma concentrations were found to be significantly higher (ANOVA = 0.000, p < 0.05) in hypertensive obese patients (10.3 +/- 2.7 pg/ml) compared to normal subjects (6.5 +/- 2.4 pg/ml), normotensive obese patients (8.3 +/- 1.5 pg/ml) and to those with essential hypertension (8.5 +/- 2.9 pg/ml). In patients with essential hypertension, a positive correlation (r = 0.493, p < 0.05) was found between adrenomedullin and endothelin-1 plasma levels.

CONCLUSIONS

These results revealed that in human obesity associated with arterial hypertension there is an increased production of plasma adrenomedullin and endothelin-1 that, with their opposite vasoactive properties (vasodilation/vasoconstriction), can contribute to this pathological association.

摘要

背景

本研究旨在调查两种内皮血管活性肽，即肾上腺髓质素（血管舒张剂）和内皮素 -1（血管收缩剂），在伴有和不伴有动脉高血压的人类肥胖症中的表现。

方法

该研究对30名肥胖受试者（体重指数>27kg/m²）进行，分为两组：15名血压正常的肥胖患者（10名男性，5名女性，平均年龄42±12岁）和15名高血压肥胖患者（9名男性，6名女性，平均年龄42±13岁）。对照组由21名正常受试者（12名男性，9名女性，平均年龄38±12岁）和16名原发性高血压患者（10名男性，6名女性，平均年龄41±12岁）组成，但无器官损害。所有研究对象均采用正常热量（20 - 22千卡/千克/天）、正常钠含量（120 - 140毫当量/天）和正常钾含量（50 - 60毫当量/天）的饮食。上午8点至9点之间，采集静脉血样用于测定（放射免疫分析法）血浆肾上腺髓质素和内皮素 -1浓度。

结果

正常受试者的血浆肾上腺髓质素水平（13.7±6.1皮克/毫升）与血压正常的肥胖患者（14.8±7.2皮克/毫升）相似，而高血压肥胖患者（22.5±9.1皮克/毫升）和原发性高血压患者（22.7±8.2皮克/毫升）的水平显著高于正常受试者和血压正常的肥胖患者（方差分析=0.000，p<0.05）。此外，发现高血压肥胖患者（10.3±2.7皮克/毫升）的内皮素 -1血浆浓度显著高于正常受试者（6.5±2.4皮克/毫升）、血压正常的肥胖患者（8.3±1.5皮克/毫升）以及原发性高血压患者（8.5±2.9皮克/毫升）（方差分析=0.000，p<0.05）。在原发性高血压患者中，肾上腺髓质素和内皮素 -1血浆水平之间存在正相关（r = 0.493，p<0.05）。