ARB降低新发糖尿病的作用机制

1、1会计学ARB降低新发糖尿病的作用机制降低新发糖尿病的作用机制ARB阻滞AT1介导的前脂肪细胞分化抑制促进胰岛素敏感小脂肪细胞生成James R. Sowers. Am J Physiol Heart Circ Physiol 286: H1597H1602, 2004;小胰岛素敏感脂细胞前细胞分化胰岛素敏感血脂血脂胰岛素抵抗大胰岛素抵抗脂细胞前细胞分化ARB促进脂肪细胞中AT2介导的代谢改善作用Lenz O & Fornoni A, Kidney International. 2008; 74: 851-853新发糖尿病风险降低23%新发糖尿病风险降低33%新发糖尿病风险降低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对对AT1/AT2受体的选择性受体的选择性30000250002000015000100005000 坎地沙坦坎地沙坦 厄贝沙坦厄贝沙坦 替米沙坦替米沙坦 氯沙坦氯沙坦 10000850030001000因此，对AT1受体的特异选择性决定了ARB的代谢改善功效Siragy HM. Am J Hypertens 2002; 15(11): 1006-14.安博维更强安博维更强AT1受体阻断受体阻断 阻断强度阻断强度安博维安博维AT1阻断作用阻断作用比缬沙坦和氯沙坦比缬沙坦和氯沙坦更强效更持久更强效更持久Burnier M. Circ

4、ulation. 2001;103;904-912安博维安博维AT1阻断作用阻断作用大约是缬沙坦的大约是缬沙坦的2倍倍和氯沙坦的和氯沙坦的3倍倍Burnier M. Circulation. 2001;103;904-912安博维降压疗效显著优于氯沙坦安博维降压疗效显著优于氯沙坦Kassler-Taub K, et al. Am J Hypertens. 1998 ;11(4 Pt 1):445-453 收缩压每下降收缩压每下降2mmHg，心血管死亡危险降低约，心血管死亡危险降低约10%安博维降压疗效显著优于缬沙坦安博维降压疗效显著优于缬沙坦Mancia G, et al. Blood Pre

5、ssure Monitoring. 2002;7:135-142收缩压每下降收缩压每下降2mmHg，心血管死亡危险降低约，心血管死亡危险降低约10%安博维药代动力学优势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促进脂肪细胞中AT2介导的代谢改善作用Lenz O & Fornoni A, Kidney International. 2008; 74: 851-853安博维