CAJ | 학술논문

目的探讨肾素-血管紧张素系统（RAS）阻断剂与代谢综合征（Mets）患者血浆脂联素水平的关系。方法53例Mets患者随机分为3组，ACEI组15例予贝那普利（5 mg/d），ARB组15例予坎地沙坦（4 mg/d），对照组23例避免应用影响RAS的相关药物，服药期为4周，检测并比较治疗前后血浆脂联素（APN）、空腹血糖（FBG）、空腹胰岛素（FINS）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、总胆固醇(TC)、低密度脂蛋白胆固醇（LDL-C）、肌酐（CR）、丙氨酸转氨酶（ALT）、胆红素（BIL）和胰岛素抵抗指数（HOMA-IR）的水平。结果 ACEI组的FBG和LDL-C、ARB组的CR治疗后低于治疗前（P＜0.05）；ACEI组和ARB组APN水平治疗后高于治疗前（P＜0.01），而3组中FINS、HOMA-IR、TC、ALT和BIL在治疗前后变化差异无统计学意义（P＞0.05）。治疗前CR、TC、ALT和BIL是APN水平的影响因素；治疗后FBG和TC是APN水平的影响因素。结论 APN可能是ACEI和ARB治疗Mets及其并发症的潜在靶点。
목적탐토신소-혈관긴장소계통（RAS）조단제여대사종합정（Mets）환자혈장지련소수평적관계。방법53례Mets환자수궤분위3조，ACEI조15례여패나보리（5 mg/d），ARB조15례여감지사탄（4 mg/d），대조조23례피면응용영향RAS적상관약물，복약기위4주，검측병비교치료전후혈장지련소（APN）、공복혈당（FBG）、공복이도소（FINS）、삼선감유（TG）、고밀도지단백담고순（HDL-C）、총담고순(TC)、저밀도지단백담고순（LDL-C）、기항（CR）、병안산전안매（ALT）、담홍소（BIL）화이도소저항지수（HOMA-IR）적수평。결과 ACEI조적FBG화LDL-C、ARB조적CR치료후저우치료전（P＜0.05）；ACEI조화ARB조APN수평치료후고우치료전（P＜0.01），이3조중FINS、HOMA-IR、TC、ALT화BIL재치료전후변화차이무통계학의의（P＞0.05）。치료전CR、TC、ALT화BIL시APN수평적영향인소；치료후FBG화TC시APN수평적영향인소。결론 APN가능시ACEI화ARB치료Mets급기병발증적잠재파점。
Objective To explore the relationship between renin-angiotensin system (RAS) blockers and plasma lev-el of adiponectin (APN) in patients with metabolic syndrome (Mets). Methods Fifty-three patients with Mets were random-ized into control group (n=23), angiotensin-convertingenzyme inhibitor (ACEI) group (benidipine, 5 mg/d, n=15) and angio-tensinll recepter blockers(ARB)group (candesartan, 4 mg/d, n=15),and were given 4-week treatment. Twenty-three pa-tients, who were avoiding application related drugs affecting the RAS for four weeks, were used as control. The values of plas-ma APN, fasting blood glucose (FBG), fasting insulin (FINS), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), creatinine(CR), aspartate aminotransferase (ALT), bil-irubin (BIL) and insulin resistance index (HOMA-IR) were detected and compared before and after treatment. Results The levels of FBG and LDL-C were significantly decreased after treatment than those before treatment in ACEI group. The level of CR was significantly lower after treatment than that before treatment in ARB group (P<0.05). The plasma APN level was significantly higher after treatment compared to that before treatment in ACEI and ARB groups (P<0.01).There were no sig-nificant differences in the values of FINS,HOMA-IR,TC,ALT and BIL between 'before and after treatment' in three groups (P>0.05). The levels of CR, TC, ALT and BIL before treatment were influencing factors for the APN level. The levels of FBG and TC after treatment were influencing factors for the APN level. Conclusion APN may serve as potential therapeu-tic targets for treating Mets and its related complications by ACEI and ARB.