Vascular Biology Center, Georgia Health Sciences University, Augusta, GA 30912, USA.
Hypertension. 2012 Nov;60(5):1273-9. doi: 10.1161/HYPERTENSIONAHA.112.196295. Epub 2012 Oct 8.
Obesity is a major risk factor for hypertension. The copresentation of hypertension and insulin resistance (IR) suggests a role for IR in blood pressure (BP) dysregulation. To test this hypothesis, peripheral IR has been genetically subtracted in a model of obesity by crossing leptin receptor mutant mice (K(db)H(PTP)) with mice lacking protein tyrosine phosphatase 1B (insulin desensitizer, H(db)K(PTP)) to generate obese insulin-sensitive mice (K(db)K(PTP)). BP was recorded in lean (H(db)H(PTP), H(db)K(PTP)) and obese (K(db)H(PTP), K(db)K(PTP)) mice via telemetry, and a frequency analysis of the recording was performed to determine BP variability. Correction of IR in obese mice normalized BP values to baseline levels (H(db)H(PTP): 116 ± 2 mm Hg; K(db)H(PTP): 129 ± 4 mm Hg; K(db)K(PTP): 114 ± 5 mm Hg) and restored BP variability by decreasing its standard deviation and the frequency of BP values over the upper autoregulatory limit of the kidneys. However, although IR-induced increases in proteinuria (versus 53 ± 13 μg/d, H(db)H(PTP)) were corrected in K(db)K(PTP) (112 ± 39 versus 422 ± 159 μg/d, K(db)H(PTP)), glomerular hypertrophy was not. IR reduced plasma aldosterone levels ruling out a role for mineralocorticoids in the development of hypertension. Taken together, these data indicate that correction of IR prevents hypertension, BP variability, and microalbuminuria in obese mice. Although the mechanism remains to be fully determined, increases in aldosterone or sympathoactivation of the cardiovascular system seem to be less likely contributors.
肥胖是高血压的一个主要危险因素。高血压和胰岛素抵抗(IR)的共存表明 IR 在血压(BP)失调中起作用。为了验证这一假设,通过将瘦素受体突变小鼠(K(db)H(PTP))与缺乏蛋白酪氨酸磷酸酶 1B(胰岛素脱敏剂,H(db)K(PTP))的小鼠杂交,在肥胖模型中从遗传学上减去外周 IR,从而产生肥胖胰岛素敏感小鼠(K(db)K(PTP))。通过遥测记录 lean(H(db)H(PTP)、H(db)K(PTP))和肥胖(K(db)H(PTP)、K(db)K(PTP))小鼠的 BP,并对记录进行频率分析,以确定 BP 变异性。肥胖小鼠的 IR 纠正使 BP 值恢复到基线水平(H(db)H(PTP):116 ± 2 mmHg;K(db)H(PTP):129 ± 4 mmHg;K(db)K(PTP):114 ± 5 mmHg),并通过降低其标准差和肾脏自动调节上限以上 BP 值的频率来恢复 BP 变异性。然而,尽管 K(db)K(PTP) 纠正了 IR 引起的蛋白尿增加(与 53 ± 13 μg/d,H(db)H(PTP)相比)(112 ± 39 与 422 ± 159 μg/d,K(db)H(PTP)相比),但肾小球肥大并未纠正。IR 降低了血浆醛固酮水平,排除了醛固酮在高血压发展中的作用。总之,这些数据表明,IR 的纠正可预防肥胖小鼠的高血压、BP 变异性和微量白蛋白尿。尽管其机制仍有待完全确定,但醛固酮增加或心血管系统的交感神经激活似乎不太可能是导致高血压的原因。