胰岛素在肥胖中的血管作用。

H Yki-Järvinen, J Westerbacka
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引用次数: 35

摘要

增加心血管疾病的患病率和发病率是腹部肥胖最重要的临床后果。尽管骨骼肌中葡萄糖处理缺陷已被广泛研究,但它们未能阐明为什么胰岛素抵抗与血管疾病有关。胰岛素的非经典作用,如对血液动力学、神经功能和止血以及脂蛋白代谢的作用,将在这方面引起更大的兴趣。现在很清楚,肥胖个体对胰岛素的一些非经典效应表现出抵抗。这些包括胰岛素对大血管顺应性作用的抵抗,抵抗血管中一氧化氮依赖性的血管舒张刺激,胰岛素激活交感神经系统,而不是其他刺激,血小板抗聚集和肝脏极低密度脂蛋白产生的抑制。对这些非典型胰岛素作用产生抵抗的确切原因尚不清楚,但对它们的理解对于理解肥胖和心血管疾病之间的联系似乎很重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Vascular actions of insulin in obesity.

An increased prevalence and incidence of cardiovascular disease is the most important clinical consequence of abdominal obesity. Although defects in glucose handling in skeletal muscle have been extensively investigated, they have failed to clarify why insulin resistance is linked to vascular disease. Non-classic actions of insulin such as those on haemodynamics, nerve function and haemostasis and on lipoprotein metabolism would appear of greater interest in this respect. It is now clear that obese individuals exhibit resistance to some of the non-classic effects of insulin. These include resistance to insulin action on large vessel compliance, nitric oxide-dependent stimulation of vasodilation in resistance vessels, activation of the sympathetic nervous system by insulin but not other stimuli, platelet anti-aggregation and suppression of hepatic very low density lipoprotein production. The exact cause(s) of resistance to these non-classic insulin actions are unclear but their understanding would seem important to understand the links between obesity and cardiovascular disease.

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