Poor glycemic control induces hypertension in diabetes mellitus
Poor glycemic control induces hypertension in diabetes mellitus
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DOI：
10.1161/01.hyp.27.3.735
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发表时间：
1996-03-01
期刊：
影响因子：
8.3
通讯作者：
Hopkins, TE
中科院分区：
文献类型：
--
作者：
Brands, MW;Hopkins, TE
我们进行这项研究是为了验证高血压是胰岛素依赖型糖尿病早期血糖控制不良的主要后果这一假设。Sprague-Dawley大鼠（n=15）置入动脉和静脉导管，置于代谢笼中，并在整个研究过程中夹紧钠摄入量。测量平均动脉压24 h/d。预对照期后，给予链脲佐菌素（70 mg/kg IV）， 15小时后开始以每天4 U/大鼠的速度持续静脉输注胰岛素。在7天的控制期后，血糖、尿钠排泄量和平均动脉压与控制前值没有差异，在控制第5至7天的平均水平分别为8.8+/-0.6 mmol/L、2.8+/-0.2 mmol/d和103+/-2 mm Hg。随后，通过降低胰岛素输注速率开始了4天的血糖控制不良期。血糖、尿钠排泄量、平均动脉压在第1天开始升高；糖尿病第3天和第4天，平均分别为23.4+/-1.0 mmol/L、3.6+/-0.1 mmol/d和110+/-2 mm Hg。所有的都显著升高。当胰岛素治疗恢复后，所有变量在接下来的4天内恢复到控制水平。第二个4天的糖尿病期也产生了类似的结果。这些结果表明，血压升高是胰岛素依赖型糖尿病患者血糖控制不良的主要后果，发生在肾损伤发生之前，因此可能是导致终末器官损伤的一个因素。
We conducted this study to test the hypothesis that hypertension is a primary consequence of poor glycemic control per se very early in insulin-dependent diabetes mellitus. Sprague-Dawley rats (n=15) were instrumented with artery and vein catheters, placed in metabolic cages, and sodium intake was clamped throughout the study. Mean arterial pressure was measured 24 h/d. After a precontrol period, streptozotocin (70 mg/kg IV) was administered, and 15 hours later a continuous intravenous insulin infusion was begun at 4 U/rat per day. The insulin infusion was titrated on an individual rat basis to maintain good glycemic control, and after this 7-day control period, blood glucose, urinary sodium excretion, and mean arterial pressure were not different from precontrol values, averaging 8.8+/-0.6 mmol/L, 2.8+/-0.2 mmol/d, and 103+/-2 mm Hg, respectively, for control days 5 through 7. Subsequently, a 4-day period of poor glycemic control was initiated by reducing the insulin infusion rate. Blood glucose, urinary sodium excretion, and mean arterial pressure began to increase on day 1; for diabetes days 3 and 4, they averaged 23.4+/-1.0 mmol/L, 3.6+/-0.1 mmol/d, and 110+/-2 mm Hg, respectively. All were significantly elevated. When insulin treatment was restored, all variables returned to control levels during the next 4 days. A second 4-day diabetic period yielded similar results. These results indicate that elevated blood pressure is a primary consequence of poor glycemic control in insulin-dependent diabetes, occurring before renal injury has had time to develop, and therefore, may be a factor contributing to the initiation of end-organ injury.