Pugh M E, Hemnes A R
Vanderbilt University Medical Center, Nashville, TN 37232, USA.
Int J Clin Pract Suppl. 2010 Nov;64(168):5-13. doi: 10.1111/j.1742-1241.2010.02523.x.
Pulmonary arterial hypertension (PAH) is a complex disease with significant morbidity and mortality. Recent animal and human studies have highlighted abnormalities in regulation and metabolism of insulin, sex hormones, adipokines and lipids that may play a role in disease development. Mouse studies suggest features of the metabolic syndrome (MS) including insulin resistance, deficiencies in peroxisome proliferator-activated receptor γ and apolipoprotein E, and low adiponectin are linked to development of PAH. In humans, insulin resistance, the MS and low levels of high-density lipoprotein have been associated with PAH. In addition, abnormal metabolism of oestrogens has been demonstrated in human and animal models of PAH, suggesting an important relationship of sex hormones and pulmonary vascular disease. Improved understanding of how metabolic and hormonal derangements relate to development and progression of pulmonary hypertension may lead to better disease therapies and understanding of potential risk factors. This review will focus on the animal and human data regarding metabolic and sex hormone derangements in PAH.
肺动脉高压（PAH）是一种具有显著发病率和死亡率的复杂疾病。最近的动物和人体研究突出了胰岛素、性激素、脂肪因子和脂质的调节及代谢异常，这些异常可能在疾病发展中起作用。小鼠研究表明，代谢综合征（MS）的特征，包括胰岛素抵抗、过氧化物酶体增殖物激活受体γ和载脂蛋白E缺乏以及脂联素水平低，与PAH的发展有关。在人类中，胰岛素抵抗、MS和高密度脂蛋白水平低与PAH有关。此外，在PAH的人类和动物模型中已证实雌激素代谢异常，这表明性激素与肺血管疾病之间存在重要关系。更好地理解代谢和激素紊乱如何与肺动脉高压的发展和进展相关，可能会带来更好的疾病治疗方法，并有助于了解潜在的风险因素。本综述将聚焦于有关PAH中代谢和性激素紊乱的动物和人体数据。
