Gardner D S, Jackson A A, Langley-Evans S C
Institute of Human Nutrition, University of Southampton, Bassett Crescent East Southampton, UK.
Hypertension. 1997 Dec;30(6):1525-30. doi: 10.1161/01.hyp.30.6.1525.
Recent epidemiological evidence suggests that adult cardiovascular risk is determined by birth weight and factors that influence birth weight, such as maternal nutrition. Data from animal models suggest that an interaction between nutrition and glucocorticoid hormones "programs" increased risk of adult hypertension. Increased fetal exposure to maternal glucocorticoids that is proposed to occur from a reduction in the placental barrier to maternal glucocorticoid, 11beta-hydroxysteroid dehydrogenase, is suggested to program hypertension in the resultant offspring from both glucocorticoid-treated and maternally protein-restricted rats. The extent to which postnatal glucocorticoid stimulation may influence the progression of hypertension in the offspring from protein-restricted rat dams was assessed in 6-week-old male Wistar rats, prenatally exposed to either an 18% casein (control) or 9% casein (low protein) diet. Rats from each dietary group were sham operated, adrenalectomized or adrenalectomized, and treated with 20 mg corticosterone/kg body weight per day. Before surgery, systolic blood pressure was significantly higher in the low protein-exposed rats compared with controls (165+/-3.8 versus 142+/-3.3 mm Hg, P<.0001). Adrenalectomy of the low protein-exposed animals significantly reduced the blood pressure to control levels, while corticosterone replacement restored the hypertensive state. No effect of adrenalectomy on blood pressure was observed in 18% casein controls. In both dietary groups adrenalectomy decreased brain, but not hepatic, glucocorticoid-sensitive enzyme activities and corticosterone treatment elevated activities of all enzymes. The data suggest that maternal diet-induced hypertension is dependent on an intact adrenal gland postnatally and that glucocorticoids are key trophic agents in maintaining the high blood pressure.
近期的流行病学证据表明,成人心血管疾病风险由出生体重及影响出生体重的因素(如母亲营养状况)所决定。动物模型数据显示,营养与糖皮质激素之间的相互作用“设定”了成年期高血压风险的增加。胎儿接触母体糖皮质激素增多,这被认为是由于胎盘对母体糖皮质激素(11β - 羟基类固醇脱氢酶)的屏障作用减弱所致,提示这会使糖皮质激素处理的大鼠及母体蛋白质限制饮食的大鼠后代出现高血压。本研究在6周龄雄性Wistar大鼠中评估了出生后糖皮质激素刺激对蛋白质限制饮食的母鼠所产后代高血压进展的影响,这些大鼠在产前分别暴露于18%酪蛋白(对照)或9%酪蛋白(低蛋白)饮食。每个饮食组的大鼠接受假手术、肾上腺切除或肾上腺切除并每天给予20 mg/kg体重的皮质酮治疗。手术前,低蛋白暴露组大鼠的收缩压显著高于对照组(165±3.8对142±3.3 mmHg,P<0.0001)。低蛋白暴露动物的肾上腺切除显著降低血压至对照水平,而皮质酮替代则恢复了高血压状态。在18%酪蛋白对照组中未观察到肾上腺切除对血压的影响。在两个饮食组中,肾上腺切除均降低了脑而非肝脏中糖皮质激素敏感酶的活性,而皮质酮治疗则提高了所有酶的活性。数据表明,母体饮食诱导的高血压在出生后依赖于完整的肾上腺,且糖皮质激素是维持高血压的关键营养因子。