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Inhibiting angiotensin type 1 receptors as a target for diabetes.

机译:抑制1型血管紧张素受体作为糖尿病的靶标。

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BACKGROUND: Angiotensin type 1 (AT1) receptor blockers (ARBs) are used to treat hypertension and related end-organ damage. ARBs have been recognised as regulators of glucose- and lipid metabolism. Clinical trials demonstrated that AT1 receptor antagonism lowers the risk for type 2 diabetes compared with other antihypertensive therapies. Blockade of AT1 receptors reduces cardiovascular morbidity and mortality in diabetic subpopulations. The mechanisms of the insulin-sensitizing/anti-diabetic effect are not fully understood, and may involve AT1 receptor-dependent pathways and 'pleiotropic' actions of ARBs including activation of insulin-sensitising PPARgamma. OBJECTIVE: In clinical practice questions about AT1 receptor blockade in diabetes have to be answered. Firstly, is selective AT1-receptor blockade superior to ACE inhibition in preventing diabetes and reducing cardiovascular end points in diabetic patients? Secondly, is an ARB with PPARgamma-activating properties superior to one without this action?RESULTS/CONCLUSION: The Ongoing Telmisartan Alone and in Combination with Ramipril Global End point Trial (ONTARGET) has provided information to answer these questions, and is discussed.
机译:背景:血管紧张素1型(AT1)受体阻滞剂(ARB)用于治疗高血压和相关的终末器官损害。 ARB被认为是葡萄糖和脂质代谢的调节剂。临床试验表明,与其他降压疗法相比,AT1受体拮抗作用可降低2型糖尿病的风险。阻断AT1受体可降低糖尿病亚群的心血管发病率和死亡率。胰岛素敏化/抗糖尿病作用的机制尚不完全清楚,可能涉及AT1受体依赖性途径和ARB的“多效性”作用,包括激活胰岛素敏化PPARγ。目的:在临床实践中必须回答有关糖尿病中AT1受体阻滞的问题。首先,在预防糖尿病和降低糖尿病患者的心血管终点方面,选择性的AT1受体阻滞优于ACE抑制吗?其次,具有PPARγ激活特性的ARB是否优于没有这种作用的ARB?结果/结论:正在进行的替米沙坦单独治疗以及与拉米普利全球终点试验(ONTARGET)的结合提供了回答这些问题的信息,并进行了讨论。

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