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血管紧张素原、性激素水平与激素治疗——动脉粥样硬化多民族研究(MESA)

Circulating Levels of Angiotensinogen, Sex Hormones, and Hormone Therapy-The Multi-Ethnic Study of Atherosclerosis (MESA).

作者信息

Lidani Karita C F, Trainor Patrick J, Buscaglia Robert, Foster Kristoff, Jaramillo Sophia, Michael Kirolos, Landry Alexander P, Michos Erin D, Ouyang Pamela, Morgan Erin S, Tsimikas Sotirios, DeFilippis Andrew P

机构信息

Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Department of Mathematics and Statistics, Northern Arizona University, Arizona, USA.

出版信息

J Clin Hypertens (Greenwich). 2025 Jun;27(6):e70083. doi: 10.1111/jch.70083.


DOI:10.1111/jch.70083
PMID:40556120
Abstract

Angiotensinogen, the unique precursor of all angiotensin hormones of the renin-angiotensin-aldosterone system (RAAS), is now a potential target in a novel pharmacological approach to hypertension. Investigating the factors that influence angiotensinogen levels, including sex hormones, may have important therapeutic implications. Plasma angiotensinogen and sex hormones levels were measured in 5171 Multi-Ethnic Study of Atherosclerosis (MESA) participants. Linear models were employed to determine the associations of angiotensinogen with sex hormones. Angiotensinogen levels were significantly higher in postmenopausal women receiving hormone therapy (HT, n = 760) compared to women not receiving HT (n = 1675) and in men (n = 2736). A positive association was present between angiotensinogen and estrogen levels that differed in magnitude between sexes and by HT status among postmenopausal women (women on HT: r = 0.44, p < 0.0001; women not on HT: r = 0.09, p = 0.0002; and men: r = 0.07, p = 0.0003). The type of HT formulation (estrogen or estrogen/progesterone) and its duration of use did not significantly affect angiotensinogen levels. This study suggests a significant role of sex, estrogen, and HT in the pathophysiology of angiotensinogen, which is important given the development and testing of angiotensinogen-targeting therapeutics.

摘要

血管紧张素原是肾素-血管紧张素-醛固酮系统(RAAS)中所有血管紧张素激素的唯一前体,目前是一种新型高血压药物治疗方法的潜在靶点。研究影响血管紧张素原水平的因素,包括性激素,可能具有重要的治疗意义。在5171名动脉粥样硬化多民族研究(MESA)参与者中测量了血浆血管紧张素原和性激素水平。采用线性模型来确定血管紧张素原与性激素之间的关联。与未接受激素治疗(HT,n = 1675)的女性和男性(n = 2736)相比,接受激素治疗的绝经后女性(n = 760)的血管紧张素原水平显著更高。血管紧张素原与雌激素水平之间存在正相关,这种相关性在性别之间以及绝经后女性中因HT状态而异(接受HT的女性:r = 0.44,p < 0.0001;未接受HT的女性:r = 0.09,p = 0.0002;男性:r = 0.07,p = 0.0003)。HT制剂的类型(雌激素或雌激素/孕激素)及其使用持续时间对血管紧张素原水平没有显著影响。这项研究表明性别、雌激素和HT在血管紧张素原的病理生理学中具有重要作用,鉴于针对血管紧张素原的治疗方法的开发和测试,这一点很重要。

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本文引用的文献

[1]
Zilebesiran: A Promising Antihypertensive Therapy Inhibiting Angiotensinogen Synthesis.

Cardiol Rev. 2025

[2]
Silencing liver angiotensinogen synthesis as a novel approach to hypertension management: promises and challenges.

Eur Heart J. 2023-10-21

[3]
Zilebesiran, an RNA Interference Therapeutic Agent for Hypertension.

N Engl J Med. 2023-7-20

[4]
Blood Levels of Angiotensinogen and Hypertension in the Multi-Ethnic Study of Atherosclerosis (MESA).

J Am Coll Cardiol. 2023-4-4

[5]
Angiotensinogen: More Than its Downstream Products: Evidence From Population Studies and Novel Therapeutics.

JACC Heart Fail. 2022-10

[6]
Angiotensinogen Suppression: A New Tool to Treat Cardiovascular and Renal Disease.

Hypertension. 2022-10

[7]
Menopausal hormone therapy and risk of incident hypertension: role of the route of estrogen administration and progestogens in the E3N cohort.

Menopause. 2021-9-27

[8]
Antisense Inhibition of Angiotensinogen With IONIS-AGT-L: Results of Phase 1 and Phase 2 Studies.

JACC Basic Transl Sci. 2021-5-3

[9]
Multi-Ethnic Study of Atherosclerosis (MESA): JACC Focus Seminar 5/8.

J Am Coll Cardiol. 2021-6-29

[10]
Sex differences in cardiovascular actions of the renin-angiotensin system.

Clin Auton Res. 2020-10

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