Department of Internal Medicine, School for Cardiovascular Diseases, CARIM, Maastricht University Medical Center, Maastricht, The Netherlands.
Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands.
J Clin Endocrinol Metab. 2018 Feb 1;103(2):759-767. doi: 10.1210/jc.2017-01541.
Impaired insulin-mediated muscle microvascular recruitment (IMMR) may add to the development of insulin resistance and hypertension. Increased aldosterone levels have been linked to these obesity-related complications in severely to morbidly obese individuals and to impaired microvascular function in experimental studies.
To investigate whether aldosterone levels are associated with IMMR, insulin sensitivity, and blood pressure in lean and moderately abdominally obese men, and to study the effect of weight loss.
DESIGN, SETTING, PARTICIPANTS, INTERVENTION, MAIN OUTCOME MEASURES: In 25 lean and 53 abdominally obese men, 24-hour blood pressure measurement was performed, and aldosterone levels were measured using ultra-performance liquid chromatography tandem mass spectrometry. Insulin sensitivity was assessed by determining whole-body glucose disposal during a hyperinsulinemic clamp. IMMR in forearm skeletal muscle was measured with contrast-enhanced ultrasonography. These assessments were repeated in the abdominally obese men following an 8-week weight loss or weight stable period.
Sodium excretion and aldosterone levels were similar in lean and abdominally obese participants, but sodium excretion was inversely associated with aldosterone concentration only in the lean individuals [lean, β/100 mmol sodium excretion (adjusted for age and urinary potassium excretion) = -0.481 (95% confidence interval, -0.949 to -0.013); abdominally obese, β/100 mmol sodium excretion = -0.081 (95% confidence interval, -0.433 to 0.271); P for interaction = 0.02]. Aldosterone was not associated with IMMR, insulin sensitivity, or blood pressure and was unaffected by weight loss.
In moderately abdominally obese men, the inverse relationship between sodium excretion and aldosterone concentration is less than that in lean men but does not translate into higher aldosterone levels. The absolute aldosterone level does not explain differences in microvascular and metabolic insulin sensitivity and blood pressure between lean and moderately abdominally obese men.
胰岛素介导的肌肉微血管募集受损（IMMR）可能会导致胰岛素抵抗和高血压的发展。在严重到病态肥胖个体中，醛固酮水平的增加与这些与肥胖相关的并发症以及实验研究中微血管功能受损有关。
研究在瘦和中度腹部肥胖男性中，醛固酮水平与 IMMR、胰岛素敏感性和血压之间是否存在关联，并研究减肥的效果。
设计、环境、参与者、干预、主要观察指标：在 25 名瘦男性和 53 名腹部肥胖男性中，进行了 24 小时血压测量，并使用超高效液相色谱串联质谱法测量了醛固酮水平。通过在高胰岛素钳夹期间测量全身葡萄糖处置来评估胰岛素敏感性。使用对比增强超声检查测量前臂骨骼肌的 IMMR。在腹部肥胖男性进行 8 周减肥或体重稳定期后，重复这些评估。
瘦和腹部肥胖参与者的钠排泄和醛固酮水平相似，但仅在瘦人群中，钠排泄与醛固酮浓度呈负相关[瘦人群，每 100mmol 钠排泄的β（调整年龄和尿钾排泄后）=-0.481（95%置信区间，-0.949 至-0.013）；腹部肥胖人群，每 100mmol 钠排泄的β=-0.081（95%置信区间，-0.433 至 0.271）；P 交互=0.02]。醛固酮与 IMMR、胰岛素敏感性或血压无关，也不受减肥的影响。
在中度腹部肥胖男性中，钠排泄与醛固酮浓度之间的负相关关系小于瘦男性，但不会转化为更高的醛固酮水平。绝对醛固酮水平不能解释瘦和中度腹部肥胖男性之间微血管和代谢胰岛素敏感性以及血压的差异。
