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缬沙坦对代谢综合征患者微量白蛋白尿和 CRP 的抑制作用(Val-Mets)。

Suppressive effects of valsartan on microalbuminuria and CRP in patients with metabolic syndrome (Val-Mets).

机构信息

Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.

出版信息

Clin Exp Hypertens. 2011;33(2):117-23. doi: 10.3109/10641963.2010.531837. Epub 2011 Jan 26.

Abstract

The presence of metabolic syndrome (Mets) increases the risk for cardiovascular disease. There is a significant correlation between the levels of urinary albumin to creatinine ratio (UACR) and high-sensitive C-reactive peptide (hs-CRP), and accumulation of each Mets component. Increasing evidence has shown the importance of blockade of renin-angiotensin-systems (RAS) for reducing urinary albumin excretion and hs-CRP levels in Mets patients. However, the impact of RAS blockade on these effects in hypertensive (HT) Mets patients without diabetes mellitus (DM) has not been evaluated. We prospectively measured the levels of UACR and hs-CRP in 153 HT patients with and without Mets. Body weight; waist circumference; presence of dyslipidemia and DM, and levels of HOMA-R, UACR, and hs-CRP were significantly higher in HT patients with Mets than in those without Mets. After we treated these Mets patients with valsartan for 6 months, blood pressure (BP), UACR, and hs-CRP were decreased, whereas body weight, HOMR-R, and the lipid profile were not changed. In HT Mets patients without DM, 6 months after valsartan administration, levels of UACR and hs-CRP were also significantly decreased by 37.8% (-9.0-56.5%, p < 0.05) and 23.6% (-28.7-73.4%, p < 0.05), respectively. However, the percentage change of UACR and hs-CRP was not correlated with the reduction in BP. Valsartan administration lowered increased levels of chronic inflammation in both HT Mets patients with DM and in those without DM. These results indicate that the anti-inflammatory properties of valsartan might also have beneficial effects in Mets patients without DM.

摘要

代谢综合征(Mets)的存在会增加心血管疾病的风险。尿白蛋白与肌酐比值(UACR)和高敏 C 反应蛋白(hs-CRP)水平与 Mets 各组成部分的堆积呈显著相关。越来越多的证据表明,抑制肾素-血管紧张素系统(RAS)对于降低 Mets 患者的尿白蛋白排泄和 hs-CRP 水平具有重要意义。然而,尚未评估 RAS 阻断对无糖尿病(DM)的高血压(HT)Mets 患者的这些影响。我们前瞻性地测量了 153 例有和无 Mets 的 HT 患者的 UACR 和 hs-CRP 水平。Mets 患者的体重、腰围、血脂异常和 DM 的存在以及 HOMA-R、UACR 和 hs-CRP 的水平均显著高于无 Mets 的患者。在用缬沙坦治疗这些 Mets 患者 6 个月后,血压(BP)、UACR 和 hs-CRP 降低,而体重、HOMR-R 和血脂谱没有改变。在无 DM 的 HT Mets 患者中,缬沙坦治疗 6 个月后,UACR 和 hs-CRP 水平分别显著降低 37.8%(-9.0-56.5%,p<0.05)和 23.6%(-28.7-73.4%,p<0.05)。然而,UACR 和 hs-CRP 的变化百分比与 BP 的降低无关。缬沙坦可降低合并或不合并 DM 的 HT Mets 患者体内慢性炎症水平的升高。这些结果表明,缬沙坦的抗炎特性可能对无 DM 的 Mets 患者也有益处。

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