肾素-血管紧张素系统活性增加可致胰岛素介导的葡萄糖利用障碍  

Insulin mediated glucose uptake may be impaired by increased activity of renin - angiotensin system

作　　者：杨万松[1,2] 黄体钢[1,2] 王尉群 樊振旺[1,2] 

机构地区：[1]天津医科大学第二医院,300211 [2]天津市心脏病学研究所

出　　处：《实用心脑肺血管病杂志》1999年第2期69-72,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的 探讨胰岛素在高肾素状态下对糖代谢的影响。方法 雄性Wistar大鼠100只随机分组,试验一组50只,其中40只不完全结扎一侧肾动脉后分为A、B两组各20只,高蔗糖饲养,B组加服依那普利;另10只为对照组,普通饲料饲养;观察术前、术后三周血压、血糖、血浆胰岛素、血浆肾素活性和血管紧张素Ⅱ水平、试验二组50只,分为a、b、c、d和e组各10只,其中a、b和c组结扎一例肾动脉,术后三周a、b和d组连续7天皮下注射胰岛素;c、e组注射等量生理盐水,a、d和e组还连续7天收集24小时尿,测尿钠,其余指标同试验一组。结果 试验一组A、B组血压,血浆肾素活性和血管紧张素Ⅱ显著升高,A组血浆胰岛素显著升高。试验二组a、d组血压,较b、e组显著升高。a组血糖较其他各组显著升高,d组则显著降低。a、b和d三组胰岛素较c、e两组显著升高。e组血浆肾素活性和血管紧张素Ⅱ以及a组血管紧张素Ⅱ较其他各组显著降低。a组尿钠于第3～5天降低,d组于3～6天升高。结论 1.肾素-血管紧张素系统活性增加可引起胰岛素介导的葡萄糖利用障碍,同时合并高糖负荷则可加速高胰岛素血症的发生,依那普利可恢复胰岛素敏感性并可防止高胰岛素血症。2.胰岛素通过激活肾素-血管紧张素系统引起血压升高。Objective To study the effect of insulin on the metabolism of glucose under the increased activity of renin - angiotensin system. Methods 100 male Wistar rats were randomly divided into two group , in group one , the left renal artery were ligated uncompletly in 40 rat, and then were divided into subgroup A and B again, each contained 20 rat, fed them with high sucrose food, enalapril was given simultaneously in subgroup B. The others (10 rats) as control, fed them only with standard feed. The changes of systolic blood pressure, plasmia glucose, plasmia insulin, plasmia renin activity (PRA) and angiotensin I (AT I ) were observed before and at the 3rd week after operation. In gruop two,30 rats were operated like group one and divided into subgroup a , b and c , each contained 10 rats, enalapril was given in subgroup b, the surplus 20 rats, as contols, they were separated into subgroup d and e. All the rats were fed with standard feed. At the 3rd week, protanine zinc insulin (10u/kg) were injected in subgroup a, b and d for 7 days, in c and e, equal volume salin were injected, 24 hours urine were collected in subgroup a, d and e for 7 days and urinary sodium were measured. The other indicators were measured as did in group one. Results In group one,systolic blood pressure,PRA and AT II were significant increased in A and B. Plasma insulin was higher in A and had no changes in B. In group two, Systolic blood pressure in a and d were significant increased than in c and e respectivily, blood glucose in a was higher than all other subgruop but d was the lowest, plasma insulin in a, b and c were higher than in c and e, PRA and AT II in e was lower than all other subgroup except AT II in a. Conclusion (1) The Increased activity of renin - angiotensin system (RAS) may impaired insulin mediated glucose uptake, and the development of hyperinsulinemia (HIS) may be accelerated during high sucrose food; but might be prevented by enalapril treatment. (2) Insulin could activize RAS which made the b

关 键 词：肾素-血管紧张素 高胰岛素血症 高血压 病理 

分 类 号：R544.102[医药卫生—心血管疾病]