Erythrocyte sodium-lithium countertransport: another link between essential hypertension and diabetes.
Erythrocyte sodium-lithium countertransport: another link between essential hypertension and diabetes.
复制标题
红细胞钠锂反转运：原发性高血压和糖尿病之间的另一个联系。
DOI：
10.1097/00041552-199409000-00006
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发表时间：
1994
影响因子：
3.2
通讯作者：
Canessa,M
中科院分区：
文献类型：
--
作者：
Canessa,M
红细胞Na+/Li+逆向转运在人类原发性高血压中已被大量临床、流行病学和遗传学研究广泛研究，并通过这些研究成为最具特征的中间表型。具有升高的反向转运蛋白活性的患者表现出高的全身可交换Na+水平、肾脏和心脏肥大以及代谢异常，其是以抵抗胰岛素刺激的身体葡萄糖处置为特征的综合征的一部分。高血压与胰岛素抵抗和升高的Na+/Li+反向转运的共存表明代谢和离子转运异常之间的联系可能通过升高的胰岛素水平介导。禁食个体红细胞的体外研究表明，生理剂量的胰岛素增加了Na+/Li+和Na+/H+交换的Na+最大转运速率和半最大转运浓度。在体内，在胰岛素抵抗性高血压患者和胰岛素依赖性糖尿病并发肾病患者中，Na+/Li+交换也表现出对Na+的低亲和力。这种反向转运蛋白的胰岛素调节可能在高血压和糖尿病中观察到的Na+稳态的慢性改变中发挥作用。
Erythrocyte Na+/Li+ countertransport has been extensively investigated in human essential hypertension in numerous clinical, epidemiologic, and genetic studies and through these studies has emerged as the best-characterized intermediate phenotype. Patients with elevated antiporter activity manifest high total body exchangeable Na+ levels, renal and cardiac hypertrophy, and metabolic abnormalities which are part of the syndrome characterized by resistance to insulin-stimulated body glucose disposal. The coexistence of hypertension with insulin resistance and elevated Na+/Li+ countertransport has suggested that a link between the metabolic and ion transport abnormalities may be mediated through elevated insulin levels. In vitro studies in erythrocytes of fasted individuals have demonstrated that physiologic doses of insulin increased the maximal transport rate and the concentration for half-maximal transport for Na+ of both the Na+/Li+ and Na+/H+ exchanges. In vivo, Na+/Li+ exchange also exhibits a low affinity for Na+ in insulin-resistant hypertensive patients and in patients with insulin-dependent diabetes melIitus complicated by nephropathy. Insulin modulation of this antiporter may play a role in the chronic alterations in Na+ homeostasis observed in hypertension and diabetes.