Visceral obesity and insulin resistance are associated with plasma aldosterone levels in women
Visceral obesity and insulin resistance are associated with plasma aldosterone levels in women
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DOI：
10.1002/j.1550-8528.1999.tb00418.x
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发表时间：
1999-07-01
期刊：
影响因子：
--
通讯作者：
Winters, SJ
中科院分区：
文献类型：
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作者：
Goodfriend, TL;Kelley, DE;Winters, SJ
目的：肥胖和胰岛素抵抗都会增加高血压和其他心血管疾病的风险，但这些异常之间的联系机制尚不清楚。本研究旨在研究肥胖、脂肪、分布和胰岛素抵抗对血浆醛固酮和其他可能导致肥胖后遗症的肾上腺类固醇水平的影响。研究方法和步骤：对28例血压正常的绝经前女性和27例血压正常的男性进行CT扫描测量内脏脂肪组织，用双能X线吸收法测量总脂肪质量、血压、胰岛素敏感性和血浆3种肾上腺类固醇激素水平。结果：女性血浆醛固酮与内脏脂肪组织呈正相关(r=0.66，p<；0.001)，与胰岛素敏感性呈负相关(r=-0.67，p<；0.001)，这些相关性不依赖于血浆肾素活性。在男性中没有相应的相关性。女性血浆醛固酮与血浆皮质醇和硫酸脱氢表雄酮显著相关。17名女性和15名男性完成了减肥方案，平均减重15.1+/-1.2公斤。体重减轻后，血浆醛固酮显著降低，胰岛素敏感性显著升高；然而，女性内脏脂肪组织和胰岛素敏感性与醛固酮的相关性仍然存在(p分别为0.09和0.07)。虽然这些女性都没有高血压，但在减肥前后血压与血浆醛固酮相关。讨论：我们得出结论：内脏肥胖症和胰岛素抵抗与血浆醛固酮和其他肾上腺类固醇激素升高有关，这可能导致肥胖女性心血管疾病。
Objective: Both obesity and insulin resistance increase the risk of hypertension and other cardiovascular diseases, but the mechanisms linking these abnormalities are unknown. The current study was undertaken to examine the effects of obesity, fat, distribution, and insulin resistance on plasma levels of aldosterone and other adrenal steroids that might contribute to sequelae of obesity. ResearchMethods and Procedures: Twenty-eight normotensive premenopausal women and 27 normotensive men with a wide range of body fat underwent measurements of visceral adipose tissue by CT scan, total fat mass by dual energy X-ray absorptiometry, blood pressure, insulin sensitivity, and plasma levels of three adrenal steroid hormones.Results: Plasma aldosterone in women correlated directly with visceral adipose tissue (r = 0.66, p < 0.001) and inversely with insulin sensitivity (r = -0.67, p < 0.001), and these associations were independent of plasma renin activity. There were no corresponding correlations in men. Plasma aldosterone was significantly correlated with plasma cortisol and dehydroepiandrosterone sulfate in women. Seventeen women and 15 men completed a weight-reduction regimen, losing an average of 15.1 +/- 1.2 kg. After weight loss, plasma aldosterone was significantly lower and insulin sensitivity higher; however, the correlations of aldosterone with visceral adipose tissue and insulin sensitivity in women persisted (p = 0.09 and 0.07, respectively). Although none of the women were hypertensive, blood pressure correlated with plasma aldosterone both before and after weight loss.Discussion: We conclude that visceral adiposity and insulin resistance are associated with increased plasma aldosterone and other adrenal steroids that may contribute to cardiovascular diseases in obese women.