Brands M W, Lee W F, Keen H L, Alonso-Galicia M, Zappe D H, Hall J E
Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson 39216-4505, USA.
Am J Physiol. 1996 Jul;271(1 Pt 2):R276-81. doi: 10.1152/ajpregu.1996.271.1.R276.
Hyperinsulinemia has been reported to cause hypertension in rats; however, the renal and hemodynamic mechanisms are not known. In this study, changes in renal function, cardiac output (CO), and total peripheral resistance (TPR) were measured during chronic insulin infusion in eight rats (approximately 350 g). After a 4-day control period, a 7-day insulin infusion was begun (1.5 mU.kg-1.min-1 iv), together with glucose (22 mg.kg-1.min-1 iv) to prevent hypoglycemia. Mean arterial pressure (MAP), CO, TPR, and heart rate were measured 24 h/day. MAP increased from 92 +/- 1 to 100 +/- 2 mmHg on day 1 and was 108 +/- 4 mmHg by day 7 of insulin. CO tended to decrease during insulin infusion, although not significantly, averaging 94 +/- 4% of the control value of 121 +/- 7 ml/min. Heart rate did not change significantly from the control value of 384 +/- 8 beats/min. TPR increased significantly to 122 +/- 11% of control by day 7. In five rats, glomerular filtration rate and effective renal plasma flow decreased to 73 +/- 4 and 66 +/- 5% of control, respectively, during insulin. Urinary sodium excretion averaged 2.6 +/- 0.1 and 2.7 +/- 0.1 meq/day during the control and insulin-infusion periods, respectively. These results indicate that insulin hypertension in rats is initiated by an increase in TPR rather than by increased CO. Also, the fact that sodium balance was maintained at elevated arterial pressure suggests that the ability of the kidneys to excrete sodium was impaired chronically during insulin infusion.
据报道,高胰岛素血症可导致大鼠患高血压;然而,其肾脏和血流动力学机制尚不清楚。在本研究中,对8只大鼠(约350克)进行慢性胰岛素输注期间,测量了它们的肾功能、心输出量(CO)和总外周阻力(TPR)。在为期4天的对照期后,开始为期7天的胰岛素输注(静脉注射1.5 mU·kg-1·min-1),同时输注葡萄糖(静脉注射22 mg·kg-1·min-1)以预防低血糖。每天24小时测量平均动脉压(MAP)、CO、TPR和心率。胰岛素输注第1天,MAP从92±1 mmHg升至100±2 mmHg,到胰岛素输注第7天时为108±4 mmHg。胰岛素输注期间,CO有下降趋势,但不显著,平均为对照值121±7 ml/min的94±4%。心率与对照值384±8次/分钟相比无显著变化。到第7天时,TPR显著升高至对照值的122±11%。在5只大鼠中,胰岛素输注期间肾小球滤过率和有效肾血浆流量分别降至对照值的73±4%和66±5%。对照期和胰岛素输注期的尿钠排泄平均分别为2.6±0.1和2.7±0.1 meq/天。这些结果表明,大鼠的胰岛素性高血压是由TPR升高而非CO增加引起的。此外,在动脉压升高时钠平衡得以维持这一事实表明,胰岛素输注期间肾脏长期排钠能力受损。