高血压合并代谢综合征患者血清瘦素与靶器官损伤的研究进展

doi:10.3969/j.issn.1000-8535.2017.02.030

摘要/Abstract

摘要： 瘦素是维持人体能量代谢平衡的蛋白质,在人体中主要由白色脂肪组织分泌,通过与瘦素受体结合发挥作用。近年来有许多与瘦素相关的研究证明高血压患者及代谢综合征患者的血清瘦素水平较健康人群明显升高。两种疾病均可出现心室肥厚,蛋白尿,动脉粥样硬化等表现,说明二者存在共同的靶器官。瘦素代谢异常可出现瘦素抵抗并通过影响肾素-血管紧张素-醛固酮系统(renin angiotensin aldosterone system, RAAS)及炎症细胞因子来损伤靶器官。本文旨在总结瘦素在高血压及代谢综合征中的作用机制,并探讨瘦素对高血压合并代谢综合征靶器官损伤作用的研究进展。

关键词: 瘦素, 瘦素抵抗, 高血压, 代谢综合征, 靶器官损伤

Abstract: Leptin is a protein that maintains the balance of energy metabolism in human body. It is mainly secreted by white adipose tissue in human body. In recent years, many studies have shown that the serum leptin level in patients with hypertension complicated with metabolic syndrome is significantly higher than that of healthy people. Both of the diseases can lead to left ventricular hypertrophy, proteinuria, atherosclerosis and other manifestations. The abnormal metabolism of leptin may contribute to leptin resistance which damages target organs by affecting the angiotensin aldosterone system and inflammatory cytokines. The aim of this article is to summarize the mechanism of leptin in hypertension and metabolic syndrome, and to explore its effect on the target organ damage in patients with hypertension complicated with metabolic syndrome.

Key words: Leptin, Leptin resistance, Hypertension, Metabolic syndrome, Target organ damage

张向宇, 徐彤彤, 胡迪聃, 王文艳. 高血压合并代谢综合征患者血清瘦素与靶器官损伤的研究进展[J]. 广州医药, 2017, 48(2): 105-108.

ZHANG Xiangyu, XU Tongtong, HU Didan, WANG Wenyan. Research progress of serum leptin level and target organ damage in patients with hypertension complicated with metabolic syndrome[J]. Guangzhou Medical Journal, 2017, 48(2): 105-108.

参考文献

[1] ALKHOLY U M, AHMED I A, KARAM N A, et al. Assessment of left ventricular mass index could predict metabolic syndrome in obese children[J]. J Saudi Heart Assoc, 2016, 28(3):159-166.
[2] I ROSTÁS, TENK J, MIKÓ A,et al. Age-related changes in acute central leptin effects on energy balance are promoted by obesity[J]. Exp Gerontol, 2016, 85:118-127.
[3] ZHOU Y, RUI L. Leptin signaling and leptin resistance [J]. Front Med, 2013, 7(2):207-222.
[4] MELE P, ZAMMARETTI F, LONGO A, et al. Sex-dependent regulation of hypothalamic neuropeptide Y-Y1 receptor gene expression in leptin treated obese (ob/ob) or lean mice[J]. Brain Res, 2016, 1649(Pt A):102-109.
[5] ALTIRRIBA J, POHER A L, ROHNER-JEANRENAUD F. Chronic Oxytocin administration as a treatment against impaired leptin signaling or leptin resistance in obesity[J]. Front Endocrinol (Lausanne), 2015(6):119.
[6] BARNES M J, MCDOUGAL D H. Leptin into the rostral ventral lateral medulla (RVLM) augments renal sympathetic nerve activity and blood pressure[J]. Front Neurosci, 2014, 8:232.
[7] BASSI M, FURUYA W I, ZOCCAL D B, et al. Facilitation of breathing by leptin effects in the central nervous system[J]. J Physiol, 2016, 594(6):1617-1625.
[8] CARMICHAEL C Y, WAINFORD R D. Hypothalamic signaling mechanisms in hypertension[J]. Curr Hypertens Rep, 2015, 17(5):39.
[9] CRUJEIRAS A B, CARREIRA M C, CABIA B, et al. Leptin resistance in obesity: An epigenetic landscape[J]. Life Sci, 2015(140):57-63.
[10] KOHARA K, OCHI M, OKADA Y, et al. Clinical characteristics of high plasma adiponectin and high plasma leptin as risk factors for arterial stiffness and related end-organ damage[J]. Atherosclerosis, 2014, 235(2):424-429.
[11] S NDA LIMA, E de OLIVEIRA, AP da SILVA, et al. Effects of Ilex paraguariensis (yerba mate) treatment on leptin resistance and inflammatory parameters in obese rats primed by early weaning[J]. Life Sci, 2014, 115(1-2):29-35.
[12] RAMÍREZ S, CLARET M. Hypothalamic ER stress: A bridge between leptin resistance and obesity[J]. FEBS Lett, 2015, 589(14):1678-1687.
[13] XUE B, YU Y, ZHANG Z, et al. Leptin mediates high-fat diet sensitization of angiotensin II-Elicited hypertension by upregulating the brain renin-angiotensin system and inflammation[J]. Hypertension, 2016, 67(5):970-976.
[14] ZEIDAN A, HUNTER J C, JAVADOV S, et al. mTOR mediates RhoA-dependent leptin-induced cardiomyocyte hypertrophy[J]. Mol Cell Biochem, 2011, 352(1/2): 99-108.
[15] FRISK M L. Inflammation resolution: a solution for advanced atherosclerosis [J]. Sci Signal, 2015, 8(365):43.
[16] ALIX P M, GUEBRE-EGZIABHER F, SOULAGE C O. Leptin as an uremic toxin: Deleterious role of leptin in chronic kidney disease [J]. Biochimie, 2014, 105(10):12-21.
[17] SHANKAR A, SYAMALA S, XIAO J, et al. Relationship between plasma leptin level and chronic kidney disease [J]. Int J Nephrol, 2012(2012):269532.
[18] LI W, HSIAO K, CHEN I, et al. Serum leptin is associated with cardiometabolic risk and predicts metabolic syndrome in Taiwanese adults[J]. Cardiovasc Diabetol, 2011(10): 36.
[19] FATIMA S S, ALAM F, CHAUDHRY B,et al.Elevated levels of chemerin, leptin, and interleukin-18 in gestational diabetes mellitus[J]. J Matern Fetal Neonatal Med, 2016(29):1-6.
[20] OSEGBE I, OKPARA H, AZINGE E. Relationship between serum leptin and insulin resistance among obese Nigerian women[J]. Ann Afr Med, 2016, 15(1):14-19.
[21] AL-DAYDAMONY M M, EL-TAHLAWI M. What is the effect of metabolic syndrome without hypertension on left ventricular hypertrophy? [J]. Echocardiography, 2016, 33(9):1284-1289.
[22] CAPOULADE R, CLAVEL M A, DUMESNIL J G, et al. Insulin resistance and LVH progression in patients with calcific aortic stenosis: a substudy of the ASTRONOMER trial[J]. JACC Cardiovasc Imaging, 2013, 6(2):165-174.
[23] MALEKI A, MONTAZERI M, RASHIDI N, et al. Metabolic syndrome and its components associated with chronic kidney disease[J]. J Res Med Sci, 2015, 20(5):465-469.
[24] LI H, LI M, LIU P, et al. Telmisartan ameliorates nephropathy in metabolic syndrome by reducing leptin release from perirenal adipose tissue[J]. Hypertension, 2016, 68(2):478-490.
[25] KAMIDE K. Role of renin-Angiotensin-Aldosterone system in metabolic syndrome and obesity-related hypertension[J]. Curr Hypertens Rev, 2014,9(4):238-245.