Saiki Atsuhito, Ohira Masahiro, Endo Kei, Koide Nobukiyo, Oyama Tomokazu, Murano Takeyoshi, Watanabe Hitoshi, Miyashita Yoh, Shirai Kohji
Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Sakura-City, Chiba 285-8741, Japan.
Metabolism. 2009 May;58(5):708-13. doi: 10.1016/j.metabol.2009.01.013.
Adipocytes express all components of the renin-angiotensin system, and the renin-angiotensin system is involved in obesity and insulin resistance. Circulating angiotensin II (Ang II) is detectable in blood, but its significance in human obesity remains unknown. The aim of this study was to investigate plasma Ang II in obese patients with type 2 diabetes mellitus (T2D) and the change during weight loss. Fifty Japanese obese subjects with T2D (body weight, 75.0 +/- 14.1 kg; body mass index, 29.1 +/- 3.7 kg/m(2); visceral fat area [VFA], 169.3 +/- 54.3 cm(2); hemoglobin A(1c), 7.6% +/- 1.5%) were enrolled. The subjects were prescribed a diet of daily caloric intake of 20 kcal/kg for 24 weeks. Plasma Ang II was measured by radioimmunoassay. Leptin, adiponectin, and lipoprotein lipase mass in preheparin serum were also measured as adipocyte-derived factors. After 24 weeks of weight reduction diet, the mean body weight, VFA, and hemoglobin A(1c) decreased significantly by 2.3%, 7.0%, and 8.3%, respectively. The mean plasma Ang II decreased by 24% (P < .0001) and correlated with body weight both at baseline (r = 0.425, P = .0018) and at 24 weeks (r = 0.332, P = .0181). The change in Ang II correlated with changes in body weight (r = 0.335, P = .0167) and VFA (r = 0.329, P = .0191). The change in Ang II also correlated positively with change in leptin (r = 0.348, P = .0127) and tended to correlate negatively with change in lipoprotein lipase mass in preheparin serum (r = -0.260, P = .0683), which is a marker of insulin sensitivity. Plasma Ang II is associated with body weight, decreases during weight loss, and is associated with markers of insulin resistance in obese subjects with T2D.
脂肪细胞表达肾素-血管紧张素系统的所有成分，且肾素-血管紧张素系统与肥胖和胰岛素抵抗有关。循环中的血管紧张素II（Ang II）在血液中可检测到，但其在人类肥胖中的意义尚不清楚。本研究的目的是调查2型糖尿病（T2D）肥胖患者的血浆Ang II水平以及体重减轻期间的变化。招募了50名日本T2D肥胖受试者（体重75.0±14.1kg；体重指数29.1±3.7kg/m²；内脏脂肪面积[VFA]169.3±54.3cm²；糖化血红蛋白7.6%±1.5%）。受试者被规定每日热量摄入为20kcal/kg的饮食，持续24周。采用放射免疫分析法测定血浆Ang II。还测定了肝素化前血清中的瘦素、脂联素和脂蛋白脂肪酶质量作为脂肪细胞衍生因子。经过24周的减重饮食后，平均体重、VFA和糖化血红蛋白分别显著下降了2.3%、7.0%和8.3%。平均血浆Ang II下降了24%（P<.0001），且在基线时（r=0.425，P=.0018）和24周时（r=0.332，P=.0181）均与体重相关。Ang II的变化与体重变化（r=0.335，P=.0167）和VFA变化（r=0.329，P=.0191）相关。Ang II的变化也与瘦素变化呈正相关（r=0.348，P=.0127），并倾向于与肝素化前血清中脂蛋白脂肪酶质量变化呈负相关（r=-0.260，P=.0683），脂蛋白脂肪酶质量是胰岛素敏感性的标志物。血浆Ang II与体重相关，在体重减轻期间降低，并且与T2D肥胖受试者的胰岛素抵抗标志物相关。
