ARB降低新發(fā)糖尿病的作用機(jī)制

1、1會(huì)計(jì)學(xué)ARB降低新發(fā)糖尿病的作用機(jī)制降低新發(fā)糖尿病的作用機(jī)制ARB阻滯AT1介導(dǎo)的前脂肪細(xì)胞分化抑制促進(jìn)胰島素敏感小脂肪細(xì)胞生成James R. Sowers. Am J Physiol Heart Circ Physiol 286: H1597H1602, 2004;小胰島素敏感脂細(xì)胞前細(xì)胞分化胰島素敏感血脂血脂胰島素抵抗大胰島素抵抗脂細(xì)胞前細(xì)胞分化ARB促進(jìn)脂肪細(xì)胞中AT2介導(dǎo)的代謝改善作用Lenz O & Fornoni A, Kidney International. 2008; 74: 851-853新發(fā)糖尿病風(fēng)險(xiǎn)降低23%新發(fā)糖尿病風(fēng)險(xiǎn)降低33%新發(fā)糖尿病風(fēng)險(xiǎn)降低36%S

2、tevo Julius, Sverre E Kjeldsen, Michael Weber, et al. Lancet 2004; 363: 202231.The KYOTO HEART Study Group. European Heart Journal (2009) 30, 24612469 .Toshio Ogihara, Kazuwa Nakao, Tsuguya Fukui, et al. Hypertension 2008;51;393-398.HR: 0.6495% CI: 0.43-0.97P = 0.033HR: 0.7795% CI: 0.690.86P 0.0001H

3、R: 0.6795% CI: 0.50.9P = 0.02817對(duì)對(duì)AT1/AT2受體的選擇性受體的選擇性30000250002000015000100005000 坎地沙坦坎地沙坦 厄貝沙坦厄貝沙坦 替米沙坦替米沙坦 氯沙坦氯沙坦 10000850030001000因此，對(duì)AT1受體的特異選擇性決定了ARB的代謝改善功效Siragy HM. Am J Hypertens 2002; 15(11): 1006-14.安博維更強(qiáng)安博維更強(qiáng)AT1受體阻斷受體阻斷 阻斷強(qiáng)度阻斷強(qiáng)度安博維安博維AT1阻斷作用阻斷作用比纈沙坦和氯沙坦比纈沙坦和氯沙坦更強(qiáng)效更持久更強(qiáng)效更持久Burnier M. Circ

4、ulation. 2001;103;904-912安博維安博維AT1阻斷作用阻斷作用大約是纈沙坦的大約是纈沙坦的2倍倍和氯沙坦的和氯沙坦的3倍倍Burnier M. Circulation. 2001;103;904-912安博維降壓療效顯著優(yōu)于氯沙坦安博維降壓療效顯著優(yōu)于氯沙坦Kassler-Taub K, et al. Am J Hypertens. 1998 ;11(4 Pt 1):445-453 收縮壓每下降收縮壓每下降2mmHg，心血管死亡危險(xiǎn)降低約，心血管死亡危險(xiǎn)降低約10%安博維降壓療效顯著優(yōu)于纈沙坦安博維降壓療效顯著優(yōu)于纈沙坦Mancia G, et al. Blood Pre

5、ssure Monitoring. 2002;7:135-142收縮壓每下降收縮壓每下降2mmHg，心血管死亡危險(xiǎn)降低約，心血管死亡危險(xiǎn)降低約10%安博維藥代動(dòng)力學(xué)優(yōu)勢(shì)1 Data on file, Bristol-Myers Squibb2 Cozaar Losartan U.S. Product Information,19953 Diovan Valsartan U.S. Product Information,19964 Criscione et al., 19955 Delacretaz et al., 19956 Morimoto and Ogihara, 19947 Klemerns et al., 1996ARB促進(jìn)脂肪細(xì)胞中AT2介導(dǎo)的代謝改善作用Lenz O & Fornoni A, Kidney International. 2008; 74: 851-853安博維