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Significant association of insulin and proinsulin with clustering of cardiovascular risk factors 被引量:1
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作者 En-ZhiJia Zhi-JianYang +9 位作者 Shi-WeiChen Guang-YaoQi Chun-FaYou Jian-FengMa Jing-XinZhang Zhen-ZhenWang Wei-ChongQian Xin-LiLi Hai-YanWang Wen-ZhuMa 《World Journal of Gastroenterology》 SCIE CAS CSCD 2005年第1期149-153,共5页
AIM: To investigate the association between true insulin and proinsulin and clustering of cardiovascular risk factors.METHODS: Based on the random stratified sampling principles, 1196 Chinese people (533 males and 663... AIM: To investigate the association between true insulin and proinsulin and clustering of cardiovascular risk factors.METHODS: Based on the random stratified sampling principles, 1196 Chinese people (533 males and 663 females,aged 35-59 years with an average age of 46.69 years) were recruited. Biotin-avidin based double monoclonal antibody ELISA method was used to detect the true insulin and proinsulin, and a risk factor score was set to evaluate individuals according to the number of risk factors.RESULTS: The median (quartile range) of true insulin and proinsulin was 4.91 mIu/L (3.01-7.09 mIu/L) and 3.49 pmol/L (2.14-5.68 pmol/L) respectively, and the true insulin level of female subjects was significantly higher than that of male subjects (P = 0.000), but the level of proinsulin displayed no significant difference between males and females (P = 0.566). The results of covariate ANOVA after age and sex were controlled showed that subjects with any of the risk factors had a significantly higher true insulin level (P = 0.002 for hypercholesterolemia, P = 0.021 for high low-density lipoprotein cholesterol, P = 0.003 for low high-density lipoprotein cholesterol, and P = 0.000 for other risk factors) and proinsulin level (P = 0.001 for low high-density lipoprotein cholesterol, and P = 0.000 for other risk factors)than those with no risk factors. Furthermore, subjects with higher risk factor scores had a higher true insulin and proinsulin level than those with lower risk factor scores (P = 0.000). The multiple linear regression models showed that true insulin and proinsulin were significantly related to cardiovascular risk factor scores respectively (P = 0.000).CONCLUSION: True insulin and proinsulin are significantly associated with the clustering of cardiovascular risk factors. 展开更多
关键词 True insulin PROINSULIN Cardiovascular diseases
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强化降脂治疗与中度降脂治疗对冠状动脉粥样硬化进展的影响—随机对照试验 被引量:13
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作者 StevenE.Nissen E.MuratTuzcu +11 位作者 PaulSchoenhagen B.GregBrown PeterGanz RobertA.Vogel TimCrowe GailHoward ChristopherJ.Cooper BruceBrodie CindyLGrines AnthonyN.DeMaria 仝其广 胡大一 《美国医学会杂志(中文版)》 2004年第4期171-180,共10页
背景:他汀类药物既可降低致动脉粥样硬化脂蛋白,也可降低心血管病的发病率和死亡率。然而,其最佳降脂方案和目标值仍未确定。目的:比较强化降脂和中度降脂方案对冠状动脉粥样斑块大小及其进展的影响。设计、地点和病例:双盲、随机... 背景:他汀类药物既可降低致动脉粥样硬化脂蛋白,也可降低心血管病的发病率和死亡率。然而,其最佳降脂方案和目标值仍未确定。目的:比较强化降脂和中度降脂方案对冠状动脉粥样斑块大小及其进展的影响。设计、地点和病例:双盲、随机和有效对照的多中心试验(积极降脂逆转动脉粥样硬化[Reversal or Atherosclerosis with Aggressive Lipid Lowering,REVERSAL]),试验于美国34个社区和三级保健中心对应用两种不同他汀治疗18个月的患者进行了疗效比较。用血管内超声测量动脉硬化的进展。从1994年7月至2001年9月,654例患者随机接受研究药物;其中502例在基线时和治疗18个月后,具有可用的血管内超声检查资料。干预:患者随机接受中度降脂(40mg普伐他汀)方案或强化降脂(80mg阿托伐他汀)方案。主要观察指标:一级疗效指标是动脉粥样斑块体积百分比变化(随诊与基线之间的差值)。结果:两组平均基线低密度脂蛋白胆固醇(LDL-C)水平是150.2mg/dL(3.8mmol/L)。治疗后,普伐他汀组LDL-C降至110mg/dL(2.85mmol/L),阿托伐他汀组降至79mg/dL(2.05mmol/L)(P<0.001)。C-反应蛋白普伐他汀组降低5.2%,阿托伐他汀组降低36.4%(P<0.001)。阿托伐他汀组动脉粥样斑块进展速度(一级终点:斑块体积百分比变化,P=0.02)显著降低;两组间二级终点指标差异相似,包括总粥样斑块体积(P:0.02)、斑块体积变化百分比(P<0.001)以及最严重病变处10mien血管段斑块体积变化(P<0.01)。与基线比较,一级终点冠状动脉粥样硬化进展的发生率普伐他汀组为2.7%(95%CI,0.2%~4.7%;P=0.001)。阿托伐他汀组无冠状动脉病变进展发生(-0.4%;95%CI,-2.4%~1.5%;P=0.98)。结论:对于冠心病患者,与普伐他汀比较,阿托伐他汀强化降脂治疗可减慢冠状动脉粥样硬化的进展。与基线比较,阿托伐他汀组动脉粥样斑块负荷无变化,而普伐他汀治疗组则显示冠状动脉粥样硬化进展。这些差异可能与阿托伐他汀在降低致动脉粥样硬化脂蛋白和C-反应蛋白方面的作用有关。 展开更多
关键词 强化降脂 中度降脂 冠状动脉粥样硬化 他汀类 导管插入
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抗高血压药物对血压正常的冠心病患者心血管事件的影响——CAMELOT研究:随机对照试验
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作者 StevenE.Nissen E.MuratTuzcu +8 位作者 PeterLibby PaulD.Thompson MagdiGhali DahliaGarza LanceBerman HarryShi EthelBuebendorf EricJ.Topoi 张宇清 《美国医学会杂志(中文版)》 2005年第1期3-11,共9页
背景:抗高血压药物对血压正常的冠状动脉病(coronary artery disease,CAD)患者心血管事件的影响仍未明确。目的:在CAD患者比较氨氯地平或依那普利与安慰剂对心血管事件的影响。设计、地点和参试者:双盲、随机、多中心临床试验。试... 背景:抗高血压药物对血压正常的冠状动脉病(coronary artery disease,CAD)患者心血管事件的影响仍未明确。目的:在CAD患者比较氨氯地平或依那普利与安慰剂对心血管事件的影响。设计、地点和参试者:双盲、随机、多中心临床试验。试验为期24个月(入选日期1999年4月至2002年4月)。试验在1991例血管造影证实有CAD(冠状动脉造影显示血管狭窄>20%)且舒张压<100mmHg的患者对氨氯地平或依那普利与安慰剂的作用进行了比较。通过血管内超声(intravascular ultrasound,IVUS)测量了274例亚研究患者动脉粥样硬化的进展。干预:患者随机接受氨氯地平10mg、依那普利20mg或安慰剂。在基线和研究结束时进行IVUS检查。主要观察指标:主要(一级)疗效指标是与安慰剂组比较氨氯地平组心血管事件的发生率。其他结果包括氨氯地平与依那普利比较以及依那普利与安慰剂的比较。事件包括心血管死亡、非致死性心肌梗死、心脏骤停复苏术、冠状动脉血管重建、因心绞痛入院、因充血性心力衰竭入院、致死性或非致死性脑卒中、短暂脑缺血发作以及新诊断的周围血管疾病。IVUS终点为动脉粥样硬化斑块体积百分比的变化。结果:基线时所有患者的平均血压为129/78mmHg;安慰剂组血压升高0.7/0.6mmHg,氨氯地平组和依那普利组分别降低4.8/2.5mmHg和4.9/2.4mmHg(与安慰剂组比较,两组P值均<0.001)。安慰剂组151例(23.1%)患者发生心血管事件,氨氯地平组110例(16.6%;风险比[hazard ratio,HR],0.69;95%,CI,0.54—0.88[P=0.003]),依那普利组136例(20.2%;HR,0.85;95%,CI,0.67~1.07[P=0.16])。依那普利组与氨氯地平组比较一级终点事件无显著差异(HR,0.81;95%CI,0.63~1.04[P=0.10])。IVUS亚研究显示,与安慰剂组比较,氨氯地平组有动脉粥样硬化进展较缓的趋势(P=0.12),在收缩压高于均值的亚组,氨氯地平则可显著延缓动脉粥样硬化的进展(P=0.02)。IVUS显示,与基线时比较,安慰剂组动脉粥样硬化明显进展(P<0.001),依那普利组有进展趋势(P=0.08),而氨氯地平组则没有进展(P=0.31)。氨氯地平组血压降低与动脉粥样硬化进展之间的相关性为r=0.19,P=0.07。结论:对血压正常的CAD患者,氨氯地平治疗可减少心血管不良事件的发生。采用依那普利治疗也有类似趋势,但是幅度较小且无显著性。IVUS所示证据表明,氨氯地平可延缓动脉粥样硬化的进展。 展开更多
关键词 抗高血压药物 血压正常 冠心病 心血管事件 随机对照试验
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Mesenteric artery remodeling and effects of imidapril and irbesartan on it in spontaneously hypertensive rats
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作者 Zhong-ShengZhu Jin-MingWang Shao-LiangChen 《World Journal of Gastroenterology》 SCIE CAS CSCD 2004年第10期1471-1475,共5页
AIM: To investigate the remodeling of mesenteric artery and the expression of TGF-β1, c-Jun in mesenteric artery and effects of imidapril and irbesartan on the remodeling in spontaneously hypertensive rats (SHR).METH... AIM: To investigate the remodeling of mesenteric artery and the expression of TGF-β1, c-Jun in mesenteric artery and effects of imidapril and irbesartan on the remodeling in spontaneously hypertensive rats (SHR).METHODS: Thirty SHR (male/female, 21/9), aged 13 wk,were randomly divided into 3 groups (7 male rats and 3 female rats each group): SHR group, imidapril group (imidapril 3 mg/kg.d was given in drinking water for 14 wk), and irbesartan group (irbesartan 50 mg/kg.d was given in drinking water foe 14 wk). Ten homogenous Wistar Kyoto rats, 5 males and 5 females, weighing 206±49 g, were selected as normal control group (WKY group). Systolic pressure was measured on d 1, 2, 4, 6, 8, 10, 12 and 14 during the experiment and the rats were killed at the end of the experiment. Angiotensin II (Ang II) level in plasma and mesenteric arteries was measured by radioimmunoassay.The morphology of the secondary branches of mesenteric artery were examined by light microscopy and electron microscopy. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect the expression of transforming growth factor TGF-β1 and c-Jun mRNA.RESULTS: Compared with imidapril group and irbesartan group, the blood pressure was remarkably increased in SHR group. Ang II level in plasma and mesenteric arteries in SHR group was the same or lower than that in WKY group, and was higher in irbesartan group and lower in imidapril group. The remodeling of mesenteric arteries in SHR group was mostly obvious among the 4 groups. The ratio of TGF-β1 absorbed light value to GAPDH absorbed light value in the SHR group was 0.887±0.019, which was significantly higher than that in WKY group, imidapril group,and irbesartan group with the ratios of 0.780±0.018,0.803±0.005, and 0.847±0.017, respectively (P<0.01).Ang II level in plasma and mesenteric arteries in imidapril group was significantly lower than that in irbesartan group (P<0.05). The c-Jun absorbed light value/GAPDH absorbed light value of mesenteric arteries in the SHR group was 0.850±0.015, which was significantly higher than that in the WKY, imidapril, and irbesartan groups (0.582±0.013,0.743±0.012, and 0.789±0.013, respectively, P<0.01), and was significantly lower in imidapril group than in irbesartan group (P<0.05).CONCLUSION:Imidapril and irbesartan can not only control blood pressure but also inhibit mesenteric arteries remodeling and mRNA expression of TEG-β1,c-Jun in SHR,Imidapril is more effective than irbesartan. 展开更多
关键词 自发性高血压 肠系膜动脉 血管重塑 咪达普利 厄贝沙坦 药理作用
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