Saiki Atsuhito, Ohira Masahiro, Endo Kei, Koide Nobukiyo, Oyama Tomokazu, Murano Takeyoshi, Miyashita Yoh, Shirai Kohji
Center of Diabetes, Endocrine and Metabolism, Sakura Hospital, School of Medicine Toho University, 564-1 Shimoshizu, Sakura-City, Chiba 285-8741, Japan.
Diabetes Res Clin Pract. 2006 Dec;74(3):242-8. doi: 10.1016/j.diabres.2006.04.004. Epub 2006 May 19.
Recent studies suggest that blockade of angiotensin type 1 (AT1) receptor may have some effect on glucose and lipoprotein metabolism. Serum level of preheparin lipoprotein lipase (LPL) reflects LPL production mainly in adipocytes and is believed to be related to insulin sensitivity. We studied the effect of a selective AT1 antagonist, valsartan, on glucose, lipid metabolism and the preheparin LPL mass in 55 patients with type 2 diabetes and hypertension. Patients were randomized into a group administered valsartan 80 mg/day for 12 weeks or a group not administered valsartan (control). Blood pressure decreased significantly. HbA1c and TG levels decreased and HDL-C level increased, but these changes tended to be significantly different. TC and LDL-C levels were not significant changes. Preheparin LPL mass increased after valsartan administration compared with control (P = 0.0307), and migration ratio of LDL (LDL-Rm), which correlated negatively with LDL particle size, decreased compared with control (P < 0.0001). DeltaLDL-Rm correlated inversely with Delta preheparin LPL mass (r = -0.459). Among subjects treated with valsartan, greater improvement in preheparin LPL mass and blood pressure was observed in the subgroup with preheparin LPL mass <40 ng/ml. The results of this study suggest that valsartan may enhance LPL production in adipocytes, resulting in enlarged LDL particle size.
近期研究表明，阻断血管紧张素1型（AT1）受体可能对葡萄糖和脂蛋白代谢有一定影响。肝素前脂蛋白脂肪酶（LPL）的血清水平主要反映脂肪细胞中LPL的产生情况，并且被认为与胰岛素敏感性有关。我们研究了选择性AT1拮抗剂缬沙坦对55例2型糖尿病合并高血压患者的葡萄糖、脂质代谢以及肝素前LPL质量的影响。患者被随机分为两组，一组给予缬沙坦80mg/天，持续12周，另一组不给予缬沙坦（对照组）。血压显著下降。糖化血红蛋白（HbA1c）和甘油三酯（TG）水平降低，高密度脂蛋白胆固醇（HDL-C）水平升高，但这些变化的差异趋于显著。总胆固醇（TC）和低密度脂蛋白胆固醇（LDL-C）水平无显著变化。与对照组相比，服用缬沙坦后肝素前LPL质量增加（P = 0.0307），与低密度脂蛋白颗粒大小呈负相关的低密度脂蛋白迁移率（LDL-Rm）与对照组相比降低（P < 0.0001）。DeltaLDL-Rm与Delta肝素前LPL质量呈负相关（r = -0.459）。在接受缬沙坦治疗的受试者中，肝素前LPL质量<40 ng/ml的亚组中，肝素前LPL质量和血压的改善更为明显。本研究结果表明，缬沙坦可能增强脂肪细胞中LPL的产生，导致低密度脂蛋白颗粒大小增大。
