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卡托普利与普伐他汀联合长期治疗对犬肥胖实验模型中胰岛素抵抗进展及心血管改变的影响。

Effects of chronic combined treatment with captopril and pravastatin on the progression of insulin resistance and cardiovascular alterations in an experimental model of obesity in dogs.

作者信息

Villa E, Rábano A, Albarrán O G, Ruilope L M, García-Robles R

机构信息

Department of Endocrinology, Hospital Ramón y Cajal, Universidad Alcalá de Henares, Madrid, Spain.

出版信息

Am J Hypertens. 1998 Jul;11(7):844-51. doi: 10.1016/s0895-7061(98)00053-3.

DOI:10.1016/s0895-7061(98)00053-3
PMID:9683046
Abstract

Obesity is a metabolic disorder in which multiple clinical and biochemical alterations coexist. However, the progression of these alterations in relation to weight gain has not been investigated in detail. Therefore, we studied the evolution of insulin resistance and associated risk factors in a model of experimental obesity in dogs. We also studied whether chronic exposure to these pathogenic factors could induce cardiac and vascular alterations. Twenty male age- and body weight-matched beagle dogs were divided into four groups (n = 5), according to diet and pharmacologic therapy received, and followed for 2 years. Control animals were maintained with a regular diet, while the 15 remaining animals were fed a high-fat diet. The Obese group of dogs received no therapy, whereas the Capto group received 25 mg/12 h captopril, and the Prava+Capto was treated with 10 mg/24 h pravastatin plus the same dose of captopril throughout the study. Periodical determinations of clinical and biochemical parameters were made, and the degree of insulin resistance was also estimated. After the 2-year follow-up, the dogs were killed and vascular thickening in the aorta and the coronary arteries was evaluated. In addition, cardiac hypertrophy was estimated by heart weight and free-wall left ventricular width. Chronic pravastatin plus captopril treatment, together with decreasing weight gain rate, ameliorated the progression of insulin resistance and associated risk factors (hyperinsulinemia, hypercholesterolemia) related to this severe model. In addition, this combined therapy showed cardioprotective action, as cardiac and vascular hypertrophy observed in the Obese group was prevented. These positive results seems to emerge from the synergistic effects of both drugs, as captopril as monotherapy induced only a slight benefit on these parameters.

摘要

肥胖是一种多种临床和生化改变并存的代谢紊乱疾病。然而,这些改变与体重增加之间的进展关系尚未得到详细研究。因此,我们在犬实验性肥胖模型中研究了胰岛素抵抗及相关危险因素的演变。我们还研究了长期暴露于这些致病因素是否会诱发心脏和血管改变。根据饮食和药物治疗情况,将20只年龄和体重匹配的雄性比格犬分为四组(每组n = 5),并随访2年。对照动物维持常规饮食,其余15只动物喂食高脂饮食。肥胖组犬不接受治疗,卡托普利组接受25 mg/12 h卡托普利治疗,普伐他汀 + 卡托普利组在整个研究过程中接受10 mg/24 h普伐他汀加相同剂量的卡托普利治疗。定期测定临床和生化参数,并评估胰岛素抵抗程度。2年随访后,处死犬只,评估主动脉和冠状动脉的血管增厚情况。此外,通过心脏重量和左心室游离壁宽度评估心脏肥大情况。慢性普伐他汀加卡托普利治疗,连同体重增加率的降低,改善了与这种严重模型相关的胰岛素抵抗及相关危险因素(高胰岛素血症、高胆固醇血症)的进展。此外,这种联合治疗显示出心脏保护作用,因为肥胖组中观察到的心脏和血管肥大得到了预防。这些积极结果似乎源于两种药物的协同作用,因为卡托普利单药治疗仅对这些参数产生轻微益处。

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