胰岛素抵抗与肺动脉高压关系的研究进展

摘要

肺动脉高压是由多种因素引起的肺血管功能及结构性异常，导致肺血管阻力增加，引发肺动脉压力升高的临床综合征。胰岛素抵抗是多种心血管疾病的重要危险因素之一，但其与肺动脉高压的关系直到近几年才受到关注。研究发现胰岛素抵抗及其伴发的高胰岛素血症、血脂紊乱、炎症反应和氧化应激，可引起肺血管紧张性增高、血管内皮功能受损以及肺血管重塑等，与肺动脉高压的发生、发展密切相关。因此，采取多种措施改善胰岛素抵抗对预防和治疗肺动脉高压具有重要意义。%Pulmonary arterial hypertension (PAH) is a common clinical syndrome characterized by dysfunction of pulmonary arterioles leading to increased vascular resistance and elevated pulmonary artery pressure. Insulin resistance (IR) is recognized as a critical risk factor for cardiovascular disease, but recent evidence suggested an association between IR and PAH. The pathological consequences of IR, such as hyperinsulinemia, dyslipidemia, chronic inflammation, and oxidative stress can cause pulmonary vasoconstriction, endothelial dysfunction and vascular remodeling, which aggravate the progressive course of PAH. Therefore, addressing the molecular mechanisms by which IR promotes the development of pulmonary hypertension and searching for appropriate interventions are important in the management of PAH.