Relationship Between Hypertensive Left Ventricular Hypertrophy And Serum Leptin,Nitric Oxide Et Al As Well As Losartan,Cilazapril Influence On Them

The relationship between hypertensive left ventricular hypertrophy (LVH) and renin-angiotensin-aldosterone system (RAAs) the sympathetic nervous-catecholamine (CA) system are clear. It has been proved that angiotensin-coverting enzyme inhibitor (ACEI) can mitigate hypertensive LVH, One of the reasons is that it can inhibite RAAs of plasma and local tissue reducing the level of AngII Ald and degradation of Bradykinin (BK) , To promote collabratly the synthesis of nitric oxide (NO). Leptin is a 167-amino acid protein transcribed from the ob gene,It can activate the sympathetic nervous-CA system and RAAs in animal test. Therefor, they regarded that theremust be some essential relationship between LVH and the level of serum Leptin.High plasma Insulin and NPY are one of important characters in essential hypertensive (EH) , which may be close relationship with occurrence, development cure and prognosis in EH. We designed the experiment in order to talk over the relationship bitween hypertensive LVH and the levels of blood Leptin NO NPY x Insulin ; on the other hand through the observation how ATi-receptor antagonist (ATRBs) ^ ACEI influence on the levels of blood Leptin NO NPY, Insulin while LVH was reduced by them, further research the mechanism of ATRBs ACEI reducing LVH.METHODWe chose 60- cases of EH patient with LVH(group I) 66 cases of EH patient without LVH(group II) 30 cases of normalcontrast human(group III) at random, the 1-2 degree of blood pressure (BP), no clear difference in years BMI sex between three groups. Group I were divided into two subgroups at random(group la : Losartan group , 30 cases ; group Ib : Cilazaprilgroup, 30 cases). After the levels of blood Leptin NO NPY Insulin and LVMI were measured, the patients of group la take losertan 50-100ing/d once per day and the patients of group Ib take Cilazapril2.5-5mg once per day in order to keepall patients BP in the level of systolic BP(SBP) 140mmHg and distolic BP(DBP) < 90mmHg. After taking the medicines over 24 weeks, LVMI and the levels of blood Leptin NO NPY Insulin were measured again in all patients. Radioimmunoassay was used to measure the levels of Leptin NPY Insulin, NO was indirectly calculated by direct measured the level of OD value. M-model echocardiography was examined in all patients, LVMI were calculated by the formula of Devereux , which was recommended by American society of Echocardiography(ASE) . Definition of LVH was LVMI >125g/m2(male) or >120g/m2(fema-le).RESULTSThere were significant difference in the levels of blood Leptin NO NPY Insulin between three groups(P < 0.001) ; mergering group I with group II to carry out multipe linear regression stepwise regression analysis which indicating the levels of serum Leptin serum NO are two key indenpent factors with the level of LVMI, No relationship with the levels of SBP DBP plasma NPYs plasma Insulin. After 24 weeks' treatment in group I, there were significant difference than before treatment in the levels of SBP DEP plasma NPY plasma Insulin serum NO serum Leptins LVMI between thetwo subgroups (P < 0.001), but group Ib ascending the level of serum NO and reducing the level of LVMI super to group Ib (P<0.05).DISCUSSIONThe results of the present study indicate that there are close essiential relation between serum Leptiru NO and LVH , It' s said that Leptin is one of the key substances which promoting factors on LVH , but NO is one of the key substances which inhibiting factors on LVH ; there may be relationship between losartan. Cilazapril inhibiting the level of serum Leptin ascending the level of serum NO and they reducing LVH ; ACEI reducing LVH and ascending the level of serum NO super to ATRBs ; the study also confirmed that ATRBs ACEI medicines can reduce the levels of plasma NPY plasma Insulin in EH with LVH.