肥満における高インスリン血症と自律神経系の機能障害: 減量による影響
M Emdin1, A Gastaldelli, E Muscelli
1Metabolism Unit and Coronary Division, CNR Institute of Clinical Physiology, and Department of Internal Medicine, University of Pisa, Pisa, Italy.
Circulation
|February 7, 2001
まとめ
肥満における慢性高インスリン血症は,心電量増加と交感神経系の活動に関連しています. 体重減少はこれらの心血管の変化を逆転させ,インスリンが示唆された.
科学分野:
- 心血管生理学 心血管の生理学
- エンドクリノロジー エンドクリノロジー
- 肥満に関する研究
背景:
- 超インスリン血症は,腎上腺活性を急激に刺激することが知られている.
- 慢性高インスリン血症は,交感性トーンと心血管疾患のリスクの増加につながる可能性があります.
研究 の 目的:
- 肥満患者の慢性高インスリン血症と交感性トーンとの関連を調査する.
- ハイパーインスリン血症とボディマス指数との関係で血液動力学と自律的機能を評価する.
主な方法:
- 測定された心電量,カテキオラミン濃度,肥満と痩せた被験者の心拍の変動.
- 分析された昼間および夜間尿中のカテキオラミンの排泄と24時間のEKGスペクトル分析.
- 血動力学と自律的マーカーは,高インスリン血症とボディマス指数と相関しています.
主要な成果:
- 肥満の被験者は,痩せた被験者と比較して,より高い心拍数と鈍化した夜間ノレピネフリン分泌を示した.
- 低周波心拍数変動力は低下し,交感性調節の低下を示した.
- 食事後の交感性優位性は,体量指数から独立して,高インスリン血症と相関しています.
結論:
- 肥満における慢性高インスリン血症は,高出力,低抵抗状態と交感神経系失調と関連しています.
- 持続的なバロレフレクスのダウンレギュレーションとエピソード的な食後の交感性優位性が観察されました.
- 体重減少はこれらの血液動力学および自律的変化を逆転させ,インスリンが因果的な役割を果たしていることを支持しました.
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