Homocysteine and Hypertension in Diabetes: Does PPARgamma Have a Regulatory Role?
Homocysteine and Hypertension in Diabetes: Does PPARgamma Have a Regulatory Role?
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DOI：
10.1155/2010/806538
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发表时间：
2010
期刊：
影响因子：
2.9
通讯作者：
Tyagi SC
中科院分区：
文献类型：
--
作者：
Sen U;Tyagi SC
大血管和微血管功能障碍是动脉粥样硬化、高血压和糖尿病等心血管疾病患者发病和死亡的主要原因。糖尿病肾病中肾小球小动脉血管收缩导致肾衰竭和肾功能受损，导致肾容量潴留和血浆同型半胱氨酸水平升高。同型半胱氨酸是一种非蛋白质氨基酸，其水平升高是一个独立的心血管危险因素。同型半胱氨酸诱导血管内皮细胞氧化损伤，通过调节基质金属蛋白酶（MMP）/金属蛋白酶组织抑制剂（TIMP）轴参与基质重塑，并增加细胞外基质蛋白（如胶原蛋白）的形成和积累。在心脏中，这会导致内皮-肌细胞解偶联增加，从而导致舒张功能障碍和高血压。在肾脏中，肾小球中基质积累增加会导致肾小球硬化，从而导致滤过不足、肾容量潴留增加和高血压。 PPARγ 激动剂可降低组织同型半胱氨酸水平，据报道可改善同型半胱氨酸引起的糖尿病血管有害效应。根据当前信息，本综述重点关注 PPARγ 激动剂对同型半胱氨酸相关高血压和糖尿病血管重塑的有益作用。
Dysfunction of macro- and microvessels is a major cause of morbidity and mortality in patients with cardio-renovascular diseases such as atherosclerosis, hypertension, and diabetes. Renal failure and impairment of renal function due to vasoconstriction of the glomerular arteriole in diabetic nephropathy leads to renal volume retention and increase in plasma homocysteine level. Homocysteine, which is a nonprotein amino acid, at elevated levels is an independent cardio-renovascular risk factor. Homocysteine induces oxidative injury of vascular endothelial cells, involved in matrix remodeling through modulation of the matrix metalloproteinase (MMP)/tissue inhibitor of metalloproteinase (TIMP) axis, and increased formation and accumulation of extracellular matrix protein, such as collagen. In heart this leads to increased endothelial-myocyte uncoupling resulting in diastolic dysfunction and hypertension. In the kidney, increased matrix accumulation in the glomerulus causes glomerulosclerosis resulting in hypofiltration, increased renal volume retention, and hypertension. PPARγ agonist reduces tissue homocysteine levels and is reported to ameliorate homocysteine-induced deleterious vascular effects in diabetes. This review, in light of current information, focuses on the beneficial effects of PPARγ agonist in homocysteine-associated hypertension and vascular remodeling in diabetes.
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