Yasue Shintaro, Ebihara Ken, Nakao Kazuwa
Division of Endocrinology and Metabolism, National Cerebral and Cardiovascular Center, Kyoto University Hospital.
Nihon Rinsho. 2012 Sep;70(9):1550-5.
Activation of the renin-angiotensin system (RAS) is commonly observed in patients with obesity. Adipose tissue expresses all components of RAS, implicating adipose renin-angiotensin system (A-RAS) in the pathophysiology of obesity. Angiotensin-converting enzyme(ACE) inhibitors and angiotensin II type 1 receptor (AT1R) blockers ameliorate obesity-related metabolic derangement. Of note, CASE-J trial demonstrated that a systemic blockade of RAS significantly reduced the incidence of newly occurring type 2 diabetes, notably in obese patients with hypertension. We reported that adipose tissue-derived AGT is substantially augmented in obesity and may contribute to hypertension in humans, thereby highlighting a pivotal role of A-RAS in systemic RAS activation and resultant metabolic derangement.
肥胖患者中常见肾素-血管紧张素系统（RAS）激活。脂肪组织表达RAS的所有成分，提示脂肪肾素-血管紧张素系统（A-RAS）参与肥胖的病理生理过程。血管紧张素转换酶（ACE）抑制剂和血管紧张素II 1型受体（AT1R）阻滞剂可改善肥胖相关的代谢紊乱。值得注意的是，CASE-J试验表明，全身性RAS阻断可显著降低新发2型糖尿病的发生率，尤其是在肥胖高血压患者中。我们报道，肥胖时脂肪组织来源的AGT显著增加，可能导致人类高血压，从而突出了A-RAS在全身性RAS激活及由此导致的代谢紊乱中的关键作用。
