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1.
目的 探讨和比较高果糖、高脂饮食诱导的小鼠肝脏三酰甘油(TG)的发生机制及其与内质网应激的关系.方法 成年雄性C57BL/J6小鼠45只,质量25~30 g,按随机数字表随机均分为对照组、高脂组及高果糖组,每组15只.对照组予以普通饲料,高果糖组予以高糖饮食,高脂组予以高脂饮食,3组每日进食热量基本相等,经喂养8周后对小鼠行葡萄糖耐量(ipGTT)实验,处死小鼠后测定各组肝脏三酰甘油含量,并测定肝脏脂质合成酶类和内质网应激相关因子的蛋白表达.结果 不同饲料喂养8周后,高果糖组和高脂组的附睾脂肪含量均为(2.0±0.1)g/100 g(质量),明显高于对照组[(1.2±0.1)g/100 g(质量)P<0.01].高果糖组和高脂组ipGTT实验后的血糖曲线下面积明显高于对照组(P<0.01).与对照组相比,高果糖组和高脂组的肝脏TG水平显著增高(P<0.01),其中高果糖组肝脏TG升高更明显,高果糖组肝脏TG水平显著高于高脂组(P<0.01).与对照组相比,高果糖组的乙酰辅酶A羧化酶( ACC)、脂肪酸合成酶(FAS)、硬脂酰辅酶A去饱和酶(SCD-1)表达增加(P<0.01),而高脂组的FAS、ACC、SCD-1的表达减少(P<0.05);反应内质网应激的磷酸化胰腺内质网激酶(p-PERK)、山梨醇要求激酶-1(p-IRE-1/t-IRE-1)和葡萄糖调节蛋白78(GRP78)蛋白表达在高果糖组和高脂组均增加(P值均<0.01).结论 高果糖饮食和高脂饮食均可引起脂肪肝,二者通过不同机制引起脂肪肝,高果糖饮食促进内源性脂质生成,高脂喂养抑制肝内源性脂质生成,两种饮食均可诱发内质网应激,提示内质网应激与饮食因子诱导的脂肪肝的发生发展有关.  相似文献   

2.
目的 观察二甲双胍对长期高饱和脂肪酸饲养大鼠肝脏腺苷酸活化蛋白激酶α(AMPKα)和PPARα表达和活性的影响,探讨二甲双胍降低肝脏胆固(TC)和甘油三酯(TG)含量的可能机制.方法 Wistar雄性大鼠30只,随机等分为:对照组(C组)、高脂组(HF组)和高脂加二甲双胍组(Met组,高脂喂养4个月,第5个月加用二甲双胍胃1个月),喂养共5个月,测定血清、肝脏组织中的TC和TG含量;分别应用实时PCR、Western印迹检测肝脏AMPKα 和PPARα 的基因转录、蛋白表达和活性水平;PPARα 转录因子DNA结合活性测定用ELISA法.结果 与C组比较,HF组大鼠肝脏AMPKα2和PPAα mRNA表达水平显著降低(均P<0.05);AMPKα 蛋白表达及活性显著降低(均P<0.05),PPARα蛋白表达及DNA结合活性分别降低 48.6%、21.6%(均P>0.05); 肝脏TC、TG含量(均P<0.05)和血TC、TG水平(均P<0.01)均显著增高.与HF组比较,Met组肝脏AMPKα2 mRNA和蛋白表达及活性显著增高(均P<0.05),PPARα蛋白表达增高56.5%(P>0.05),其DNA结合活性显著增高(P<0.05);肝脏TC、TG含量血TC、TG水平均显著降低(均P<0.05).结论 二甲双胍降低长期高脂饲养所致的大鼠肝脏、血中TC、TG水平的增高,可能与其激活肝细胞AMPKα及PPARα有关.  相似文献   

3.
目的探讨高果糖与高脂饮食对比诱导的小鼠肝脏内质网应激(ERS)的发生时程变化。方法雄性C57BL/J6小鼠分为对照组、高果糖组及高脂组,分别在喂养3 d、8 w后测定各组小鼠空腹血糖(FPG)、空腹血清胰岛素(FINS)、肝脏甘油三酯(TG)含量,并测定各组小鼠肝脏ERS标志物——磷酸化胰腺内质网激酶(p-PERK)及磷酸化山梨醇要求激酶-1(p-IRE1/t-IRE1)的蛋白表达。结果喂养3 d后,与对照组相比,两组FPG、FINS无明显变化,而肝TG水平均显著增加;喂养8 w后,与对照组相比,两组FPG、FINS、肝TG水平均显著增加;喂养3 d后,与对照组相比,高果糖组的肝内p-PERK、p-IRE1蛋白表达显著增加,提示出现ERS,而高脂组GRP78、p-PERK的蛋白表达与对照组无显著区别;喂养8 w后,高果糖、高脂组的肝内p-PERK、p-IRE1蛋白表达均显著增加。结论短期和长期高果糖和高脂喂养均可引起肝内脂质沉积,但高果糖喂养小鼠在脂肪肝发生早期即可出现肝ERS,而高脂喂养小鼠则在长期喂养后方出现肝ERS,提示ERS与高果糖、高脂饮食诱导的脂肪肝发生发展均有关,但介导机制不同。  相似文献   

4.
目的观察利拉鲁肽对高脂喂养大鼠内质网应激标记蛋白葡萄糖调节蛋白(GRP78)及c-Jun氨基端激酶(JNK)蛋白的表达及肝脏脂质沉积的影响。方法以高脂饮食喂养方法建立IR大鼠模型,成模后随机分为对照组(Con)、高脂组(HFD)、低剂量利拉鲁肽组(LL)、高剂量利拉鲁肽组(HL)。药物干预2周后,每组随机取5只行高胰岛素-正葡萄糖钳夹实验。结果与HFD和LL组比较,HL组肝脏内TG(~L TG)降低(P0.05)。Western blot结果显示,与HFD和LL组比较,HL组GRP78[(1.24±0.13)vs(0.97±0.04)vs(0.62±0.17),P0.05]及JNK下降[(0.38±0.01)vs(0.21±0.01)vs(0.12±0.02),P0.05]。电镜结果显示,HFD组肝细胞内有大量脂质,粗面内质网明显扩张,脱颗粒现象明显;HL组肝细胞内无脂质蓄积存在,粗面内质网扩张及脱颗粒现象得到显著缓解。相关分析结果显示,GRP78、JNK蛋白表达量与FFA、~LTG呈正相关,与葡萄糖输注率(GIR)呈负相关。结论利拉鲁肽可呈浓度依赖性改善高脂喂养大鼠脂代谢异常和肝脏脂质沉积,减轻IR,其作用机制可能与肝脏GRP78/JNK通路受抑有关。  相似文献   

5.
目的:探讨胰岛素抵抗在非酒精性脂肪性肝发病中的作用及机制,观察二甲双胍对高脂饲养大鼠肝脏脂肪变的干预效果.方法:21只(?) Wistar大鼠分为3组,每组7只,普通饮食组(SD),高脂饮食组(HF),二甲双胍组(HF- Met)在高脂饮食的同时给予二甲双胍,共8wk.8 wk末处死大鼠,称量附睾脂肪,计算肝指数,生化方法测定ALT、AST、TG、TC、FFA、SOD和MDA.放免法测定空腹胰岛素,逆转录聚合酶链反应(RT-PCR)和ELISA法检测肝脏TNF-αmRNA和蛋白的表达,用葡萄糖输注率(GIR)来评价胰岛素敏感性,并观察肝组织病理变化.结果:与HF相比,HF-Met肝细胞脂肪变和小叶炎症明显减轻,肝指数、胰岛素、AST、ALT、TG、FFA显著下降(3.25±0.26 vs 4.29±0.12,33.37±8.34 vs 46.73±5.24,17.29±5.34 vs 43.48±6.21,4.10±2.47 vs 12.05±4.05,P<0.01;106.0±31.04 vs 141.37±24.87,48.31±16.11 vs 88.34±21.94,P<0.05)TNF-α的表达也显著下降,GIR增加(7.58±1.05 vs 6.31±1.28,P<0.05).结论:二甲双胍干预能明显改善高脂饲养大鼠的胰岛素抵抗,降低肝脏TG、FFA和TNF-α的表达,减轻肝脏脂肪变的程度,提示胰岛素增敏治疗可能是NAFLD防治的一种积极策略.  相似文献   

6.
目的探讨内质网应激(ERS)抑制剂4-苯基丁酸(4-PBA)对高果糖饮食诱导小鼠肝脏脂质沉积及脂质从头合成通路的影响。方法雄性Wistar小鼠分为对照组、高果糖组和4-PBA组(自高果糖喂养第4周后给予4-PBA 1 g·kg-1·d-1),8 w后处死小鼠并测定各组小鼠空腹血糖(FBG)、空腹血胰岛素(FINS),测定血清谷丙转氨酶(ALT)、谷草转氨酶(AST)含量及肝脏甘油三酯(TG)含量;测定ERS标志物葡萄糖调节蛋白(GRP)78、GRP94的基因表达;并测定脂质合成标志物固醇调节元件结合蛋白(SREBP)-1c和乙酰辅酶A羧化酶(ACC)的基因表达。结果与对照组相比,高果糖组的FBG、FINS、肝TG均显著增加(均P0.01);与高果糖组比较,4-PBA组的上述指标均显著降低(均P0.01)。与对照组相比,高果糖组小鼠的肝内GRP78、GRP94基因表达显著增加(均P0.01),而4-PBA组上述基因表达均低于高果糖组(均P0.01)。高果糖组小鼠的肝内SREBP-1c和ACC基因表达显著增加(均P0.01),而4-PBA组上述因子基因表达均显著低于高果糖组(P均0.01)。结论长期高果糖喂养引起小鼠肝脏脂质沉积、ERS和脂质从头合成增加,ERS抑制剂4-PBA可改善高果糖饮食诱导的脂肪肝,其机制可能与ERS调控脂质从头合成有关。  相似文献   

7.
目的 观察氧化苦参碱对高果糖饮食诱导小鼠肝脏脂质沉积和肝胰岛素敏感性的影响.方法 雄性C57BL/J6小鼠分为对照组、高果糖组和氧化苦参碱组(自高果糖喂养第4周后给予氧化苦参碱40 mg/kg),喂养8 w后对小鼠行腹膜下葡萄糖耐量试验(ipGTT),处死小鼠后测定各组空腹血糖、血胰岛素及肝脏甘油三酯(TG)含量,通过比较各组小鼠注射胰岛素后肝脏的磷酸化Akt/总Akt (p-Akt/t-Akt)和磷酸化GSK-3α/β/总GSK-3 α/β(p-GSK-3 α/β/t-GSK-3α/β)表达的比值变化评估肝脏胰岛素敏感性.结果 与对照组相比,高果糖组的血葡萄糖、血胰岛素、ipGTT曲线下面积及肝TG均显著增加(均P<0.01);氧化苦参碱干预组的血葡萄糖、血胰岛素、葡萄糖耐量试验曲线下面积及肝TG均较高果糖组减低(均P<0.01);与对照组相比,高果糖组胰岛素注射肝内的p-Akt/t-Akt及p-GSK-3 α/β/t-GSK-3 α/β均显著降低(均P<0.01),而氧化苦参碱组胰岛素注射后肝内的p-Akt/t-Akt及p-GSK-3β/t-GSK-3β较高果糖组显著升高(均P<0.01).结论 慢性高果糖喂养可引起小鼠肝脏脂质沉积和肝胰岛素抵抗,氧化苦参碱治疗可改善高果糖喂养诱导的脂肪肝和肝胰岛素敏感性.  相似文献   

8.
目的探讨内质网应激(ERS)在高脂饮食2型糖尿病转基因MKR小鼠脂肪肝发生中的作用。方法高脂饲料诱发MKR鼠形成脂肪肝,观察肝脏形态变化,检测肝脏甘油三酯和脂肪酸水平,RT-PCR检测小鼠肝脏内质网应激相关基因mRNA表达变化。结果与正常小鼠比较,MKR组小鼠肝脏GRP78、XBP1、FAS、ACC-α、GSK3βmRNA表达水平升高(P0.05);与MKR小鼠比较,高脂饮食MKR小鼠肝脏甘油三酯(TG)和脂肪酸(FFA)水平显著升高(P0.01),肝脏GRP78、XBP1、CHOP、SREBP1c、FAS、ACC-α、GSK3β和EDEM1基因mRNA表达水平均增加(P0.01),而Apo B100 mRNA表达水平降低(P0.01)。结论 ERS参与调节肝脏脂质及Apo B100的代谢过程,在转基因2型糖尿病MKR鼠脂肪肝形成中发挥重要作用。  相似文献   

9.
目的探讨二甲双胍对非酒精性脂肪性肝炎(NASH)的治疗作用和机制。方法36只雄性Wistar大鼠分为正常对照组(8只),喂养基础饲料,NASH组(28只),通过喂饲高脂饲料建立NASH大鼠模型,12w末处死NASH组4只,病理证实造模成功后,进一步将NASH组随机分为二甲双胍组、饮食治疗组和模型对照组(每组各8只)。二甲双胍组给予二甲双胍156mg·kg-1·d-1,饮食治疗组和模型对照组均给予等容积生理盐水灌胃,除模型对照组外,其余各组均转以基础饲料喂养,继续饲养12w后,空腹处死所有动物。分别检测各组大鼠肝功能、血糖、血脂、胰岛素和TNF-α水平,肝组织病理切片检查炎症坏死程度,RT-PCR检测组织TNF-αmRNA的表达。结果模型对照组大鼠肝组织表现为不同程度的脂肪变性、炎症坏死和纤维化,肝功能、血脂及胰岛素抵抗指数等各项指标均较正常组显著增高。二甲双胍能显著降低肝组织中TNF-αmRNA表达,明显改善肝组织脂肪变性、炎症坏死程度及各项血清学指标,饮食治疗组TNF-αmRNA的表达亦降低,肝组织学一定程度改善,但各项血清学指标仍持续增高。结论TNF-α表达增强参与了NASH的发生发展,应用二甲双胍可以抑制肝脏TNF-α基因的表达,调节肝脏脂肪代谢和改善肝组织炎症坏死。  相似文献   

10.
目的观察二甲双胍对小鼠血清可溶性瘦素受体(sOB-R)水平的影响。方法健康雄性C57BL/6小鼠42只,随机分为正常饮食(CD)组及高脂饮食(HF)组。对CD组及HF组分别予不同剂量二甲双胍灌胃及蒸馏水灌胃,1次/d,共15d。ELISA测定小鼠血清sOB-R水平,Real-time PCR检测肝脏瘦素受体基因(OB-Rt)表达水平及在L02细胞上检测二甲双胍对OB-Rt水平的影响。结果灌胃后,HF组FPG及胰岛素抵抗指数(HOMA-IR)较CD组降低、糖耐量改善,血清sOB-R水平较对照组升高(P0.05)。HF组肝脏OB-Rt mRNA表达水平高于对照组(P0.05);培养的L02细胞经二甲双胍(10mM)处理后OB-Rt的mRNA表达水平较对照组升高(P0.05)。结论二甲双胍能剂量依赖性上调小鼠血清sOB-R水平,该作用可能是通过刺激肝脏OB-Rt基因表达实现的。  相似文献   

11.
Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.  相似文献   

12.
Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm2) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.  相似文献   

13.
Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.  相似文献   

14.
The immunoneuroendocrine role of melatonin   总被引:19,自引:0,他引:19  
Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.  相似文献   

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Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.  相似文献   

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Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.  相似文献   

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Aim

Genetic polymorphisms of the human angiotensinogen gene are frequent and may induce up to 30% increase of plasma angiotensinogen concentrations with a blood pressure increase of up to 5 mmHg. Their role for the pathogenesis of human arterial hypertension remains unclear. High plasma angiotensinogen levels could increase the sensitivity to other blood pressure stressors.

Methods

Male transgenic rats with a 9-fold increase of plasma angiotensinogen concentrations and male non-transgenic rats aged 10 weeks were treated or not with NG-Nitro-L-arginine-methyl ester for 3 weeks in their drinking water (n = 3/group). Systolic blood pressure and body weight were measured at baseline and at the end of the study when left ventricular weight and ventricular expression of angiotensin I-converting enzyme and procollagen Iα1 were determined (polymerase chain reaction).

Results

At baseline, transgenic rats had +18 mmHg higher bood pressure and –8% lower body weight compared to non-transgenic rats (P < 0.05) without significant changes for the vehicle groups throughout the study (P > 0.05). NG-Nitro-L-arginine-methyl ester increased blood pressure, left ventricular weight and left ventricular weight indexed for body weight by +41%, +17.6% and +18.6% (P < 0.05) in transgenic and +25%, +5.3% and +6.7% (P > 0.05) in non-transgenic rats compared to untreated animals, respectively. Cardiac gene expression showed no differences between groups (P > 0.05).

Conclusion

Increased plasma angiotensinogen levels may sensitize to additional blood pressure stressors. Our preliminary results point towards an independent role of angiotensinogen in the pathogenesis of human hypertension and associated end-organ damage.  相似文献   

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