Masuzaki Hiroaki, Yamamoto Hiroshi, Kenyon Christopher J, Elmquist Joel K, Morton Nicholas M, Paterson Janice M, Shinyama Hiroshi, Sharp Matthew G F, Fleming Stewart, Mullins John J, Seckl Jonathan R, Flier Jeffrey S
Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA.
J Clin Invest. 2003 Jul;112(1):83-90. doi: 10.1172/JCI17845.
Obesity is closely associated with the metabolic syndrome, a combination of disorders including insulin resistance, diabetes, dyslipidemia, and hypertension. A role for local glucocorticoid reamplification in obesity and the metabolic syndrome has been suggested. The enzyme 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) regenerates active cortisol from inactive 11-keto forms, and aP2-HSD1 mice with relative transgenic overexpression of this enzyme in fat cells develop visceral obesity with insulin resistance and dyslipidemia. Here we report that aP2-HSD1 mice also have high arterial blood pressure (BP). The mice have increased sensitivity to dietary salt and increased plasma levels of angiotensinogen, angiotensin II, and aldosterone. This hypertension is abolished by selective angiotensin II receptor AT-1 antagonist at a low dose that does not affect BP in non-Tg littermates. These findings suggest that activation of the circulating renin-angiotensin system (RAS) develops in aP2-HSD1 mice. The long-term hypertension is further reflected by an appreciable hypertrophy and hyperplasia of the distal tubule epithelium of the nephron, resembling salt-sensitive or angiotensin II-mediated hypertension. Taken together, our findings suggest that overexpression of 11beta-HSD1 in fat is sufficient to cause salt-sensitive hypertension mediated by an activated RAS. The potential role of adipose 11beta-HSD1 in mediating critical features of the metabolic syndrome extends beyond obesity and metabolic complications to include the most central cardiovascular feature of this disorder.
肥胖与代谢综合征密切相关,代谢综合征是一种包括胰岛素抵抗、糖尿病、血脂异常和高血压在内的多种紊乱的组合。局部糖皮质激素再放大在肥胖和代谢综合征中的作用已被提出。11β-羟基类固醇脱氢酶1型(11β-HSD1)可将无活性的11-酮形式的皮质醇再生为活性皮质醇,脂肪细胞中该酶相对转基因过表达的aP2-HSD1小鼠会出现内脏肥胖,并伴有胰岛素抵抗和血脂异常。在此我们报告,aP2-HSD1小鼠也有高动脉血压(BP)。这些小鼠对饮食中的盐敏感性增加,血浆中血管紧张素原、血管紧张素II和醛固酮水平升高。低剂量的选择性血管紧张素II受体AT-1拮抗剂可消除这种高血压,而该剂量对非转基因同窝小鼠的血压无影响。这些发现表明,aP2-HSD1小鼠中循环肾素-血管紧张素系统(RAS)被激活。长期高血压进一步表现为肾单位远端小管上皮细胞明显肥大和增生,类似于盐敏感性或血管紧张素II介导的高血压。综上所述,我们的发现表明,脂肪中1-1β-HSD1的过表达足以导致由激活的RAS介导的盐敏感性高血压。脂肪11β-HSD1在介导代谢综合征关键特征中的潜在作用不仅限于肥胖和代谢并发症,还包括该疾病最核心的心血管特征。