瘦素(leptin)是由控制各种生理过程的脂肪组织合成和分泌的一类激素,通过作用于靶细胞膜上的瘦素受体并经信号传导在各器官和系统中发挥一系列生物学效应。肾脏是高血压常见的靶器官之一。相关研究表明,瘦素在高血压肾损害中发挥作用,其机制可能与氧化应激及其炎症反应有关。本文以瘦素对高血压肾损害及其相关机制作一综述,并探讨瘦素对高血压肾损害发病机制研究进展。

Leptin which is a kind of synthesis and secretion of hormone that participates in various physiological processes is the role of the leptin receptor on the target cell membrane and the signal transduction through a series of biological effects in different organs and systems. Kidney is one of the common target organs of hypertension, and related research shows that leptin plays a role in hypertensive kidney damage, whose mechanism may be related to oxidative stress and its inflammatory reaction. The paper reviewed leptin on renal damage in hypertension and its related mechanisms, to explore the leptin on renal pathogenesis of hypertension research progress.

目的 观察平胃散联合耳穴治疗单纯性肥胖的临床疗效及其对血清神经肽Y(Neuropeptide Y,NPY)和瘦素(Leptin,LP)水平的影响。方法 64例单纯性肥胖患者,采用数字表法随机分为治疗组33例和对照组31例。治疗组予口服平胃散免煎颗粒配合耳穴治疗,对照组予口服奥利司他胶囊治疗,疗程4周。观察治疗前后体质量、体质量指数(bodymass index,BMI)、体脂百分比(Fat%,F%)、腰臀比(Waist Hip Ratio,WHR)、NPY、LP的变化。结果 治疗后,治疗组和对照组体质量、BMI、F%、WHR、相关疾病的危险度均下降(P＜0.001)。比较治疗前后体质量、BMI、F%、WHR差值,治疗组下降均比对照组明显(P＜0.01、P＜0.001)。治疗组临床疗效优于对照组(P＜0.05)。治疗组和对照组血清NPY、LP水平均下降(P＜0.001),且治疗组较对照组下降(P＜0.001)。结论 平胃散联合耳穴有较好的减肥作用,其机制可能是通过降低血清中NPY、LP含量。

Objective Clinical observation of Pingwei Powder combined with auricular point therapy in treating simple obesity and the effect on serum NPY and leptin Levels. Methods 64 cases of simple obesity patients were randomized into treatment group(33 cases) and control group(31 cases). The treatment group was given Pingwei Powder combined with auricular point therapy.The control group was given Orlistat capsules. After being treated for 4 weeks, body weight, bodymass index(BMI), fat% (F%), waist hip ratio (WHR),neuropeptide y (NPY) and leptin(LP) were determined. Results After post-treatment in treatment group and control group, body weight, BMI, F%, WHR, the risk of related diseases all decreased (P＜0.001), The body weight, BMI, F%, WHR before and after treatment were lower than those in the control group(P＜0.01, P＜0.001). The clinical efficacy of the treatment group was better than that of the control group(P＜0.05). Serum NPY and LP levels in treatment group and control group were decreased (P＜0.001), and that the treatment group were lower than of the control group (P＜0.001). Conclusion Pingwei Powder combined with auricular point therapy have better in weight loss, which is possibly by way of reducing serum NPY, LP Levels.

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。

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.