天津医药

• 论著 •    

肾素-血管紧张素系统阻断剂与代谢综合征患者脂联素水平的关系

赵姜   

  1. 天津市公安医院内三科
  • 收稿日期:2013-01-18 修回日期:2013-05-20 出版日期:2013-10-15 发布日期:2013-10-15
  • 通讯作者: 赵姜

Relationship between Renin-Angiotensin System Blockers and Plasma Level of Adiponectin in Patients with Metabolic Syndrome

ZHAO Jiang   

  1. Tianjin Public Security Hospital
  • Received:2013-01-18 Revised:2013-05-20 Published:2013-10-15 Online:2013-10-15
  • Contact: ZHAO Jiang

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摘要：

 【摘要】 目的  探讨肾素-血管紧张素系统（RAS）阻断剂与代谢综合征（Mets）患者血浆脂联素水平的关系。  方法  53例Mets患者随机分为3组，ACEI组15例予贝那普利（5mg/d），ARB组15例予坎地沙坦（4mg/d），对照组23例避免应用影响RAS的相关药物，服药期为4周，检测并比较治疗前后血浆脂联素（APN）、空腹血糖（FBG）、空腹胰岛素（FINS）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、总胆固醇(TC)、低密度脂蛋白胆固醇（LDL-C）、肌酐（CR）、丙氨酸转氨酶（ALT）、胆红素（BIL）和胰岛素抵抗指数（HOMA-IR）的水平。  结果  ACEI组的FBG和LDL-C、ARB组的CR治疗后低于治疗前（P＜0.05）；ACEI组和ARB组APN水平治疗后高于治疗前（P＜0.01），而3组中FINS、HOMA-IR、TC、ALT和BIL在治疗前后变化差异无统计学意义（P＞0.05）。治疗前CR、TC、ALT和BIL是APN水平的影响因素；治疗后FBG和TC是APN水平的影响因素。  结论  APN可能是ACEI和ARB治疗Mets及其并发症的潜在靶点。

关键词: 肾素-血管紧张素系统, 血管紧张素转换酶抑制剂, 脂联素, 代谢综合征, 受体, 血管紧张素, 2型, 血管紧张素Ⅱ1型受体拮抗剂

Abstract: [Abstract]???Objective???To explore the relationship between renin-angiotensin system (RAS) blockers and plasma level of adiponectin (APN) in patients with metabolic syndrome (Mets).??Methods?? Fifty-three patients with Mets were randomized into control group (n=23), angiotensin-convertingenzyme inhibitor (ACEI) group (benidipine, 5mg /d,n=15) and angiotensinll recepter blockers（ARB）group (candesartan,4mg/d,n=15)，and were given4-week treatment. Twenty-three patients, who were avoiding application related drugs affecting the RAS for four weeks, were used as control. The values of plasma APN, fasting blood glucose (FBG), fasting insulin (FINS), triglyceride (TG), high-density lipoprotein cholesterol (HDLC), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), creatinine(CR), aspartate aminotransferase (ALT), bilirubin (BIL) and insulin resistance index (HOMA-IR) were detected and compared before and after treatment.???Results??? The levels of FBG and LDL-C were significantly decreased after treatment than those before treatment in ACEI group. The level of CR was significantly lower after treatment than that before treatment in ARB group (P＜0.05). The plasma APN level was significantly higher after treatment compared to that before treatment in ACEI and ARB groups (P＜0.01).There were no significant differences in the values of FINS，HOMA-IR，TC，ALT and BIL between'before and after treatment' in three groups (P＞0.05). The levels of CR, TC, ALT and BIL before treatment were influencing factors for the APN level. The levels of FBG and TC after treatment were influencing factors for the APN level.??Conclusion?? APN may serve as potential therapeutic targets for treating Mets and its related complications by ACEI and ARB.

Key words: renin-angiotensin system, angiotensin-converting enzyme inhibitors, adiponectin, Metabolic syndrome X, receptor, angiotensin, type2, 血管紧张素Ⅱ1型受体拮抗剂