Mak R H, Wong J H
Department of Pediatrics, Stanford University School of Medicine, Calif. 94305.
Miner Electrolyte Metab. 1992;18(2-5):156-9.
Recent evidence suggests a pathogenetic link between hypertension and insulin resistance. In addition, disturbances of vitamin D/parathyroid hormone axis have been reported in various hypertensive and insulin-resistant states. Chronic renal failure is characterized by high incidence of hypertension, insulin resistance and disturbances in the vitamin D/parathyroid hormone axis. Preliminary studies in both patients and rats with end-stage renal disease who were hypertensive, insulin resistant and 1,25-dihydroxycholecalciferol deficient with hyperparathyroidism; parenteral administration of pharmacological doses of 1,25-dihydroxycholecalciferol led to reversal of hypertension and insulin resistance without significant changes in serum calcium or parathyroid hormone concentrations. Thus, vitamin D deficiency may be an important factor in the pathogenesis of hypertension and insulin resistance in end-stage renal disease.
近期证据表明高血压与胰岛素抵抗之间存在发病机制上的联系。此外，在各种高血压和胰岛素抵抗状态下均有维生素D/甲状旁腺激素轴紊乱的报道。慢性肾衰竭的特点是高血压、胰岛素抵抗以及维生素D/甲状旁腺激素轴紊乱的发生率较高。对患有高血压、胰岛素抵抗且1,25 - 二羟胆钙化醇缺乏并伴有甲状旁腺功能亢进的终末期肾病患者和大鼠进行的初步研究表明；胃肠外给予药理剂量的1,25 - 二羟胆钙化醇可使高血压和胰岛素抵抗得到逆转，而血清钙或甲状旁腺激素浓度无显著变化。因此，维生素D缺乏可能是终末期肾病中高血压和胰岛素抵抗发病机制中的一个重要因素。
