Bambino Gesù Children's Hospital and Research Institute, Research Unit for Multifactorial Disease, Rome, Italy.
BMC Med. 2012 May 30;10:53. doi: 10.1186/1741-7015-10-53.
In patients with metabolic syndrome, body iron overload exacerbates insulin resistance, impairment of glucose metabolism, endothelium dysfunction and coronary artery responses. Conversely, iron depletion is effective to ameliorate glucose metabolism and dysfunctional endothelium. Most of its effectiveness seems to occur through the amelioration of systemic and hepatic insulin resistance. In a study published by BMC Medicine, Michalsen et al. demonstrated a dramatic improvement of blood pressure, serum glucose and lipids after removing 550 to 800 ml of blood in subjects with metabolic syndrome. This effect was apparently independent of changes in insulin resistance, in contrast to previous cross-sectional and cohort studies investigating the association between iron overload, insulin resistance and cardiovascular disease. Despite drawbacks in the study design, its findings may lead the way to investigations aimed at exploring iron-dependent regulatory mechanisms of vascular tone in healthy individuals and patients with metabolic disease, thus providing a rationale for novel preventive and therapeutic strategies to counteract hypertension. Please see related article: http://www.biomedcentral.com/1741-7015/10/54.
在患有代谢综合征的患者中，体内铁过载会加重胰岛素抵抗、损害葡萄糖代谢、内皮功能障碍和冠状动脉反应。相反，铁耗竭可有效改善葡萄糖代谢和功能失调的内皮细胞。其大部分疗效似乎是通过改善全身和肝脏胰岛素抵抗而实现的。在 BMC Medicine 发表的一项研究中，Michalsen 等人证明，在代谢综合征患者中去除 550 至 800 毫升血液后，血压、血清葡萄糖和血脂显著改善。与之前调查铁过载、胰岛素抵抗与心血管疾病之间关联的横断面和队列研究相反，这种作用显然与胰岛素抵抗的变化无关。尽管该研究设计存在缺陷，但它的发现可能为探索健康人群和代谢性疾病患者血管张力的铁依赖性调节机制提供依据，从而为对抗高血压提供新的预防和治疗策略的依据。请参阅相关文章：http://www.biomedcentral.com/1741-7015/10/54。
