Penesova Adela, Radikova Zofia, Cizmarova Eva, Kvetnanský Richard, Blazicek Pavel, Vlcek Miroslav, Koska Juraj, Vigas Milan
Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia.
Ann N Y Acad Sci. 2008 Dec;1148:490-4. doi: 10.1196/annals.1410.036.
The interrelationship between activity of sympathetic nervous system and metabolic risk factors in youth with hypertension (HT) has been poorly studied. The aim of our present study was to assess the interrelationship between metabolic risk factors, such as insulin resistance, concentration of plasminogen activator inhibitor (PAI)-1, and catecholamines in an early stage of HT onset. An oral glucose tolerance test was performed in 17 young males with early-diagnosed nontreated HT grade 1 and 16 gender-, age-, and BMI-matched normotensive controls. Concentrations of glucose, insulin, epinephrine, norepinephrine, PAI-1, and plasma renin activity (PRA) were determined in venous plasma. Insulin sensitivity indices (ISIs) proposed by Cederholm, Matsuda, and Gutt were calculated. HT had higher baseline levels of norepinephrine, insulin (P= 0.02), and PAI-1 (P= 0.04). ISIs were lower in HT subjects (P < 0.001). Baseline concentrations of epinephrine were negatively associated with HDL cholesterol (r=-0.415, P= 0.02), ISI Matsuda (r=-0.361, P= 0.04), ISI Cederholm (r=-0.354, P= 0.04), and ISI Gutt (r=-0.429, P= 0.01), and positively with PRA (r= 0.609, P < 0.0001). Positive association was found between baseline concentrations of norepinephrine and PAI-1 (r= 0.418, P= 0.02). The sympathetic overactivity, which occurs in the early stage of HT may contribute to reduced insulin sensitivity even in young patients and intensify the undesirable development of metabolic cardiovascular risk factors and progress of the disease.
高血压（HT）青年患者交感神经系统活动与代谢危险因素之间的相互关系尚未得到充分研究。我们当前研究的目的是评估代谢危险因素之间的相互关系，如胰岛素抵抗、纤溶酶原激活物抑制剂（PAI）-1浓度以及HT发病早期的儿茶酚胺。对17名早期诊断为未经治疗的1级HT青年男性和16名性别、年龄和体重指数匹配的血压正常对照者进行了口服葡萄糖耐量试验。测定静脉血浆中葡萄糖、胰岛素、肾上腺素、去甲肾上腺素、PAI-1和血浆肾素活性（PRA）的浓度。计算了由Cederholm、Matsuda和Gutt提出的胰岛素敏感性指数（ISIs）。HT患者去甲肾上腺素、胰岛素（P = 0.02）和PAI-1（P = 0.04）的基线水平较高。HT患者的ISIs较低（P < 0.001）。肾上腺素的基线浓度与高密度脂蛋白胆固醇呈负相关（r = -0.415，P = 0.02）、与Matsuda ISI呈负相关（r = -0.361，P = 0.04）、与Cederholm ISI呈负相关（r = -0.354，P = 0.04）、与Gutt ISI呈负相关（r = -0.429，P = 0.01），与PRA呈正相关（r = 0.609，P < 0.0001）。去甲肾上腺素的基线浓度与PAI-1之间存在正相关（r = 0.418，P = 0.02）。HT早期出现的交感神经过度活跃可能导致即使在年轻患者中胰岛素敏感性降低，并加剧代谢性心血管危险因素的不良发展和疾病进展。
