Zamami Yoshito, Takatori Shingo, Yamawaki Kousuke, Miyashita Satoko, Mio Mitsunobu, Kitamura Yoshihisa, Kawasaki Hiromu
Department of Clinical Pharmaceutical Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
Hypertens Res. 2008 May;31(5):1033-44. doi: 10.1291/hypres.31.1033.
Recent clinical studies have demonstrated that transient postprandial hyperglycemia and hyperinsulinemia may contribute to the development of hypertension. Therefore, we investigated the influence of acute hyperglycemia and/or hyperinsulinemia induced by glucose or insulin infusion on neuronal and humoral control of vascular tone in rats. Euglycemic male Wistar rats were pithed under anesthesia and arterial blood pressure was measured. Changes in vascular responses to spinal cord stimulation (SCS) and intravenous bolus injections of noradrenaline, angiotensin II, calcitonin gene-related peptide (CGRP), acetylcholine and sodium nitroprusside (SNP) were studied by infusing various concentrations of glucose or insulin. Continuous glucose infusion, which increased both blood glucose and serum insulin levels, significantly augmented adrenergic nerve-mediated pressor responses to SCS without affecting pressor responses to injection of noradrenaline or angiotensin II. In pithed rats with artificially increased blood pressure and blockade of autonomic outflow, glucose infusion attenuated CGRPergic nerve-depressor responses to SCS without affecting depressor responses to injection of CGRP, acetylcholine or SNP. In pithed rats treated with octreotide, which increased blood glucose without increasing serum insulin levels, glucose infusion caused only significant augmentation of adrenergic nerve-mediated pressor responses. Combined infusion of insulin and glucose, which resulted in increased serum insulin levels with euglycemia, significantly augmented adrenergic nerve-mediated pressor responses and attenuated CGRPergic nerve-mediated depressor responses. The present results suggest that acute hyperglycemia and hyperinsulinemia increase adrenergic nerve-mediated vasoconstriction, which in turn blunts CGRPergic nerve function, and that the increase in plasma insulin concentration associated with hyperglycemia may be responsible for the alteration of neuronal vascular regulation.
近期临床研究表明,餐后短暂性高血糖和高胰岛素血症可能促使高血压的发生。因此,我们研究了通过输注葡萄糖或胰岛素诱导的急性高血糖和/或高胰岛素血症对大鼠血管张力的神经和体液控制的影响。在麻醉状态下对血糖正常的雄性Wistar大鼠实施脊髓破坏术,并测量动脉血压。通过输注不同浓度的葡萄糖或胰岛素,研究对脊髓刺激(SCS)以及静脉推注去甲肾上腺素、血管紧张素II、降钙素基因相关肽(CGRP)、乙酰胆碱和硝普钠(SNP)的血管反应变化。持续输注葡萄糖可使血糖和血清胰岛素水平均升高,显著增强肾上腺素能神经介导的对SCS的升压反应,而不影响对注射去甲肾上腺素或血管紧张素II的升压反应。在人为升高血压并阻断自主神经传出的脊髓破坏大鼠中,输注葡萄糖减弱了CGRP能神经介导的对SCS的降压反应,而不影响对注射CGRP、乙酰胆碱或SNP的降压反应。在用奥曲肽治疗的脊髓破坏大鼠中,奥曲肽使血糖升高但不增加血清胰岛素水平,输注葡萄糖仅显著增强肾上腺素能神经介导的升压反应。联合输注胰岛素和葡萄糖可使血清胰岛素水平升高且血糖正常,显著增强肾上腺素能神经介导的升压反应并减弱CGRP能神经介导的降压反应。目前的结果表明,急性高血糖和高胰岛素血症会增加肾上腺素能神经介导的血管收缩,进而削弱CGRP能神经功能,并且与高血糖相关的血浆胰岛素浓度升高可能是神经元血管调节改变的原因。