Iams S G, Wexler B C
Br J Exp Pathol. 1977 Apr;58(2):177-99.
In order to investigate the combined effects of diabetes and hypertension on the pathogenesis of cardiovascular disease, adult male and female SHR rats which develop hypertension spontaneously were given a single, 10 mg or 15 mg/100 g body wt. injection of alloxan s.c. to induce moderate or severe diabetes. Insulin was deliberately withheld. Animals were examined by autopsy daily for 7 days post-alloxan and after 4 and 8 weeks. Mortality was high--only 52% of the males survived as against 80% of the females. Most deaths occurred on Day 5 and were associated with adrenal haemorrhage and hyperplasia, thymus galnd involution, fatty liver and marked hypotension despite elevated aldosterone levels. During the first week, corticosterone levels increased significantly in the male; in females they showed little change. After 4 weeks, the severly diabetic animals became emaciated and moribund; corticosterone and aldosterone levels fell to very low levels despite adrenal hyperplasia. The beta cells of the moderately diabetic animals eventually lost their ability to secrete insulin and these animals too became cachetic and moribund with concomitant elevation of lipid, glucose and BUN levels, as well as myocardial infarction, fatty liver, and generalized hyalin arteriolo-, arterio-, and nephrosclerosis. It is suggested that the combined hormonal and metabolic alterations of diabetes and hypertension reinforced one another in these spontaneously hypertensive rats, leading to intense stimulation of the hypothalamic-pituitary-adrenal system, the exacerbation of those cardiovascular degenerative changes known to be associated with uncontrolled diabetes or hypertension, eventual impaired adrenocortical steroidogenesis, hypotension and death.
为了研究糖尿病和高血压对心血管疾病发病机制的联合作用,对成年自发性高血压雄性和雌性SHR大鼠皮下注射10 mg或15 mg/100 g体重的单次剂量四氧嘧啶,以诱导中度或重度糖尿病。故意不给予胰岛素。在四氧嘧啶注射后7天以及4周和8周后,每天对动物进行尸检。死亡率很高——雄性大鼠仅52%存活,而雌性大鼠为80%。大多数死亡发生在第5天,与肾上腺出血和增生、胸腺萎缩、脂肪肝以及尽管醛固酮水平升高但仍有明显低血压有关。在第一周,雄性大鼠的皮质酮水平显著升高;雌性大鼠则变化不大。4周后,重度糖尿病动物变得消瘦和濒死;尽管肾上腺增生,但皮质酮和醛固酮水平降至非常低的水平。中度糖尿病动物的β细胞最终失去分泌胰岛素的能力,这些动物也变得恶病质和濒死,同时脂质、葡萄糖和尿素氮水平升高,以及心肌梗死、脂肪肝和全身性透明样小动脉、动脉和肾硬化。提示在这些自发性高血压大鼠中,糖尿病和高血压的激素和代谢改变相互强化,导致下丘脑-垂体-肾上腺系统受到强烈刺激,那些已知与未控制的糖尿病或高血压相关的心血管退行性改变加剧,最终肾上腺皮质类固醇生成受损、低血压和死亡。