THE EFFECT OF WEIGHT-LOSS ON THE SENSITIVITY OF BLOOD-PRESSURE TO SODIUM IN OBESE ADOLESCENTS
THE EFFECT OF WEIGHT-LOSS ON THE SENSITIVITY OF BLOOD-PRESSURE TO SODIUM IN OBESE ADOLESCENTS
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DOI：
10.1056/nejm198908313210905
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发表时间：
1989-08-31
影响因子：
158.5
通讯作者：
MARTIN, M
中科院分区：
文献类型：
--
作者：
ROCCHINI, AP;KEY, J;MARTIN, M
为了阐明钠摄入量在肥胖受试者血压调节中的作用，我们测量了60名肥胖青少年和18名非肥胖青少年在连续两周的高盐饮食(每天250 mmolNa)和低盐饮食(<；30 mmold)后的血压。当他们从高盐饮食改变为低盐饮食时，肥胖组的平均变化明显更大(.+-。平均动脉压(-12.±-1 mm Hg)显著高于非肥胖组(+1.±2 mm Hg；P<；0.001)。最能预测钠敏感程度的变量是空腹血浆胰岛素水平，给予低盐饮食时的血浆醛固酮水平，给予高盐饮食时的血浆去甲肾上腺素水平，以及脂肪构成的体重百分比。其中51名肥胖青少年也在为期20周的减肥计划前后进行了研究。减肥计划结束后，体重减轻超过1公斤的36名受试者的血压对钠的敏感度降低(高盐饮食与低盐饮食的血压值之差为-1.+-1毫米汞柱)。其余15名青少年的血压对钠摄入量(-11.±-0.3毫米汞柱)仍然敏感。这些结果支持这样一种假设，即肥胖青少年的血压对饮食中的钠摄入量很敏感，这种敏感性可能是由于肥胖的特征--高胰岛素血症、高醛固酮血症和交感神经系统活动增加的综合影响。
To clarify the role of sodium intake in the regulation of blood pressure in obese subjects, we measured blood pressure in 60 obese and 18 nonobese adolescents after successive two-week periods of a high-salt diet (> 250 mmol sodium per day) and a low-salt diet (< 30 mmol per day). When they were changed from a high-salt to a low-salt diet, the obese group had a significantly larger mean change (.+-. SE) in mean arterial pressure (-12.+-.1 mm Hg) than did the nonobese group (+1.+-.2 mm Hg; P < 0.001). The variables that best predicted the degree of sodium sensitivity were the fasting plasma insulin level, the plasma aldosterone level while the low-salt diet was being given, the plasma norepinephrine level while the high-salt diet was being given, and the percentage of body weight made up by fat. Fifty-one of the obese adolescents were also studied before and after a 20-week weight-loss program. After the weight-loss program, the 36 subjects who lost more than 1 kg of body weight had a reduced sensitivity of blood pressure to sodium (difference from value during high-salt diet to that during low-salt diet, -1.+-.1 mm Hg). The blood pressure of the remaining 15 adolescents was still sensitive to sodium intake (-11.+-.3 mm Hg). These results support the hypothesis that the blood pressure of obese adolescents is sensitive to dietary sodium intake and that this sensitivity may be due to the combined effects of the hyperinsulinemia, hyperaldosteronism, and increased activity of the sympathetic nervous system that are characteristic of obesity.