Section of Cardio-Renal Physiology and Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham.
Hypertension. 2022 Jul;79(7):1395-1408. doi: 10.1161/HYPERTENSIONAHA.121.18690. Epub 2022 May 12.
Emerging evidence over the past several years suggests that diurnal control of sodium excretion is sex dependent and involves the renal endothelin system. Given recent awareness of disruptions of circadian function in obesity, we determined whether diet-induced obesity impairs renal handling of an acute salt load at different times of day and whether this varies by sex and is associated with renal endothelin dysfunction.
Male and female Sprague-Dawley rats were placed on a high-fat diet for 8 weeks before assessing renal sodium handling and blood pressure.
Male, but not female, rats on high fat had a significantly reduced natriuretic response to acute NaCl injection at the beginning of their active period that was associated with lower endothelin 1 (ET-1) excretion, lower ET-1 mRNA expression in the cortex and outer medulla as well as lower ET receptor expression in the outer medulla of the high-fat rats. Obese males also had significantly higher blood pressure (telemetry) that was exacerbated by adding high salt to the diet during the last 2 weeks. While female rats developed hypertension with a high-fat diet, they were not salt sensitive and ET-1 excretion was unchanged.
These data identify diet-induced obesity as a sex-specific disruptive factor for maintaining proper sodium handling. Although high-fat diets induce hypertension in both sexes, these data reveal that males are at greater risk of salt-dependent hypertension and further suggest that females have more redundant systems that can be productive against salt-sensitive hypertension in at least some circumstances.
过去几年的新证据表明,钠排泄的昼夜节律控制具有性别依赖性,涉及肾脏内皮素系统。鉴于肥胖症中昼夜节律功能紊乱的最新认识,我们确定了饮食诱导的肥胖症是否会在一天中的不同时间损害肾脏对急性盐负荷的处理能力,以及这种情况是否因性别而异,并与肾脏内皮素功能障碍有关。
雄性和雌性 Sprague-Dawley 大鼠在接受高脂肪饮食 8 周后,评估肾脏钠处理和血压。
高脂肪饮食的雄性大鼠而非雌性大鼠在活动期开始时对急性 NaCl 注射的利尿反应明显降低,这与内皮素 1(ET-1)排泄减少、皮质和外髓 ET-1mRNA 表达降低以及外髓 ET 受体表达降低有关高脂肪大鼠。肥胖雄性大鼠的血压(遥测)也明显升高,在最后 2 周饮食中添加高盐会加重这种情况。虽然高脂肪饮食会导致雌性大鼠高血压,但它们对盐不敏感,ET-1 排泄没有变化。
这些数据表明,饮食诱导的肥胖症是维持适当钠处理的性别特异性破坏因素。虽然高脂肪饮食会导致两性高血压,但这些数据表明,男性患盐依赖性高血压的风险更高,并进一步表明,女性具有更多冗余系统,至少在某些情况下可以对抗盐敏感性高血压。