02-Mavromatidis

Transcription

1 13A ｧ8 Yapple 閨 , 2-3: , 2005 AN ﾞ6ｾ4 ﾒO09 ﾇ6ｾ4 ﾇ ﾇ 0ｸ7apple 閨 fi 046ｦ ﾒ. 09 0ｸ ｧ9 090ｹ0 6ﾑ8. ﾒ ｧ9 080ｸ7 096ﾑ806ｦﾐ ﾇ03 ﾇ To fi 046ｦ ｧ9ｨB applefi 07026ｧ ｸ7036ｧ90709, ｧ8 0ｸ7apple 閨 , fi0708 0ｸ apple ｧ9, fi0708 apple ｦ0 026ｦ0apple080ｸ7 apple 040ｸ ｧ9. 6ﾑ8apple 閨0ｹ 閨02000ｹ0 apple080ｸ7 閨 ｸ702 6ｧ ｧ9 陦 fi0206 0ｸ7apple ｧ8 040ｸ70404 閨 ｦ ｹ0 apple 040ｸ ｧ9 0ｹ ｹ0 0ｸ7apple 閨 ｹ ｧ907 0ｸ707080ｹ ｹ ｹ ｹ0 0ｸ7apple 閨 ｹ apple 046ｦ ｸ70ｹ ｧ90ｹ0, ｧ fi02 07 閨04080ｸ ｦ0 026ｦ0apple080ｸ ｧ ｸ7 036ｧ9apple080ｸ70ｹ0, 006ｧ ｹ 閨0ｹ0 apple ｸ704076ｧ 閨 ｸ702086ｦ00ｹ0 apple080ｸ7 閨04080ｸ fi 040ｷ fi ｹ0. 6ｾ fiapple ｸ7026ｧ ｦ ｧ ｧ ｹ0 0ｸ7apple 閨 ｹ0, apple086ｧ ｧ apple fi ｸ7 0007fi0ｹ0 ( 6ｦ ｸ7 02fi07080ｸ ｸ7 040ｸ700apple ｦ0, 06 閨 ｸ ｧ907090ｹ ｧ907090ｹ fi07090ｹ0, 00006ｧ90ｷ ｷ apple 03 09fi07020ｷ307, fiapple0ｷ30ｹ ｸ ｧ9-080ｸ ｸ7 ｨB ｸ ｦ ｸ ｦ0 040ｷ ｦ0 6ｦ ｹ ｧ9080ｸ7). 6ﾑ8apple6ｧ ｹ0, ｦ ｹ fi fi04080ｸ70ｹ0, fiapple0ｷ30ｹ0 006ｧ ｧ9, , ｹ0 00apple6ｧ904090ｹ apple000ｸ ｧ8 apple 03 閨 apple080ｸ7 096ｧ ｸ7apple apple006ｧ ｹ0 apple 040ｸ ｧ9 0ｹ0. 6ｾ ﾌｦ ﾇｦ ﾞ ｨC 6ﾑ809ｦﾐ04 ﾇ09ｦﾐ ﾌ ﾌ 罔ﾐ ﾞ ｦ fi 046ｦ apple ｧ9 006ｧ9 apple ｧ fi apple080ｸ ｧ9ｨB applefi 07026ｧ ｸ7036ｧ90709, ｧ8 0ｸ7apple 閨 ( ﾞ08), fi0708 0ｸ7apple apple ｧ9, fi0708 apple ｧ8 apple 040ｸ ｧ9. O06 00apple 閨0ｹ ｹ0 apple080ｸ7 閨 ｸ702 6ｧ ｧ9 09 apple 040ｸ ｧ9 08 6ｧ ｧ9ｨB ｦ ｹ0 040ｸ70407fi ｹ ｹ0 ﾞ08. 6ﾑ fi ｧ907-0ｸ707080ｹ ｹ0 ﾞ ｸ70ｹ0 apple 046ｦ ｸ70ｹ0, 020ｸ7036ｧ90ｷ30ｹ0 0ｸ702086ｦ00ｹ0 apple080ｸ7 閨04080ｸ ｧ ｧ ｸ7 036ｧ9apple080ｸ70ｹ01,2, 006ｧ apple ｹ0 040ｸ ｸ702086ｦ00ｹ0 apple080ｸ7 閨04080ｸ ｸ fi 040ｷ fi ｹ03. 6ｾ46ｦ000080ｷ 閨0209 Framingham 0ｸ7apple ｧ9ｨB fi % % 020ｷ307 apple000306apple ｷ307 ﾞ ｹ ｸ707 6ｧ902000ｹ ｧ apple08 6ｧ apple 040ｸ ｧ9 4. ﾞIｦ ｦﾐ ﾞ ｨC 09 ﾇ01 ﾞ03ｦﾐ6ｾ409 ﾌI fi ｦ 006ｧ800 縺0303 ﾒ ｧ80ｹ0 O ｧ ｸ70ｹ0 08apple086ｧ9080ｸ70ｹ0 0ｸ ｧ8 apple6ｧ ( ﾞ09) ｸ70ｹ0 apple 046ｦ ｸ70ｹ ｧ9ｨB ｦ ｷ ｸ7-04apple ｧ90ｷ ｷ ｸ , 閨0ｹ ｹ ｧ ｹ ｸ7 Na ｸ7 ﾇ 2 O ｧ ｸ 閨 fi ｸ7 040ｸ700apple ｦ ｸ ｦ0 040ｸ ｧ ｹ0 (6ｾ4036ｾ4) ｸ 閨0709 apple03fi ｧ9 0ｷ307 ( 6ｦ

2 13A ｧ8 Yapple 閨 , 14, 閨 ｹ apple ｧ907090ｹ0) ｧ ｧ90ｷ ｷ307 00apple06apple 陦0ｷ ｹ0 00apple6ｧ ｧ90ｷ304090ｹ ｹ0 apple03fi ｧ80ｹ ｸ70ｹ apple 046ｦ ｸ70ｹ0 apple ｦ00ｹ0 閨 apple ｧ9 06 閨 fi ｹ0 0ｸ7apple ｧ80ｹ0 0ｸ ｸ ｹ ｹ0 020ｸ ｧ907090ｹ0 ( 閨07ｨB0ｸ70008 apple080ｸ7 000ｸ7036ｦ ｦ ), fi ｹ0 0ｸ7apple ｧ80ｹ ｧ80ｹ0 閨 ｹ0 020ｷ ｸ7apple 閨0ｷ307, fiapple0ｷ30ｹ0 00apple6ｧ904090ｹ ｦ ｷ307 0ｸ7apple 閨0ｷ307 0ｸ ｸ70ｹ ｦ00ｹ06, ｧ ｹ0 040ｸ700apple ｧ80ｹ fi ｹ ｹ0 00apple 02fi03080ｸ703090ｹ0 ﾞ ｧ ｷ ｧ90ｷ ｹ0 ﾞ ｧ 閨0ｷ ｷ ｸ7apple 閨0ｷ ﾇ 06 閨 ｸ7 6ｾ4036ｾ ｦ ｹ0 ﾞ09 00apple ｧ apple6ｧ904090ｹ0 applefi ｸ7apple ｸ ｧ9 ( 07026ｧ ｹ ｸ7036ｧ907090ｹ0), apple080ｸ ｷ ｧ ｸ ｦ0 040ｸ707 03fi00080ｸ78,9. 6ｾ ｧ apple0802 閨 ｧ apple026ｧ , fi apple080ｸ7 apple applefi apple08026ｦ apple ｧ9 08 ｯ 0007fi0ｹ0 6ｧ ｦ 閨 ｹ apple03fi ｧ80ｹ0, 08 ｯ 0002 閨03080ｸ7 00apple ｧ fi. ﾇ 07026ｧ ｹ0 0300apple026ｧ907090ｹ0 (0ｸ7apple apple ｧ9 ) apple080ｸ7 apple ｧ ｸ70ｹ0 apple 046ｦ ｸ70ｹ0, ｧ ｾ4036ｾ 閨04080ｸ7 0ｸ7apple ｸ7apple08080ｸ ｹ0, apple080ｸ ｧ fi0009 0ｸ7applefi 閨03000ｸ ｸ ｸ7 0300apple026ｧ ｹ apple ｦ00ｹ0, apple6ｧ9apple ｧ ｸ ｸ7 apple ｹ0 apple 046ｦ ｷ apple0ｷ307, 08 6ｧ ｦ ｹ0 00 閨04090ｹ0 ﾞ ｾ40ｸ70404 閨 ｹ0 ﾞ ｹ0 apple 040ｸ ｧ9 0ｹ0 0ｸ7apple ｧ907090ｹ ｧ907090ｹ fi07090ｹ ｸ707 apple ｧ ｸ70ｹ0 apple 046ｦ ｸ70ｹ0 0ｸ 閨07 00apple6ｧ9apple fi ｹ ｧ907090ｹ0 apple ｹ014, ｹ ｸ 閨0709 apple ｷ3096ｧ fi07080ｸ715, 0000 apple0802 閨 ｸ ｦ004apple fi090ｷ3 apple 03080ｸ7046ｧ9 0ｹ ｧ ｹ0 ｦﾐｦﾐ (AG-II). ﾇ AG-II 閨 ｧ9 6 5 閨 fi0206 閨 apple ｯ 000ｸ703006ｧ9 0ｹ fi 07000ｸ fi 046ｦ ( ﾒ036ｾ4), 08086ｦ0 閨09040ｸ7046ｧ ｹ apple0807 0ｸ ｧ ｧ9 ( ｸ apple6ｧ9apple00 ) apple ｧ8 6ｦ ｹ0 ﾞ ｦ 閨03080ｹ apple ｹ ｦ0apple0708 apple080ｸ ｧ9ｨB080ｸ apple 046ｦ ｸ apple6ｧ ｦ ｸ704apple ｸ , ｦ ｹ ｸ700apple ｧ fi ｸ ｹ apple6ｧ9apple ｹ0 AG-II ｧ907090ｹ0. ﾇ apple 046ｦ ｸ70ｹ ｧ80ｹ0 ﾞ08, 09 08apple086ｧ ｹ0 076ｦ ｹ0, apple03 鐶pple 閨 ｸ7applefi ｹ0 07apple ｹ ｦ0apple ,18. ﾇ 00006ｧ90ｷ ｷ ｸ ｸ7036ｧ90ｷ30ｹ ｸ ｧ9080ｸ ｸ7 ｨB ｸ7 (03O) ｧ9ｨB ｸ7036ｧ apple026ｧ ｾ402080ｸ70ｹ0 apple - 046ｦ ｸ70ｹ ｧ ｸ7036ｧ90709 apple ｧ ｷ ｹ fi ｹ ｹ ｸ7036ｧ907090ｹ0 07 apple 閨 ｧ ｧ ｧ ｯ 0ｸ702fi 03000ｷ303006ｧ ｧ8 0ｸ ｸ703096ｧ9 9, fiapple080ｸ7 0ｸ7apple ｧ80ｹ0 apple ｷ3096ｧ8 03O 6ｧ ｧ ｸ7 applefi ｦ ｹ0 036ｧ9ｨB000ｹ ｸ709fi07080ｸ7. ﾇ 0300apple026ｧ ｸ ｧ apple ｷ3096ｧ8 03O, 08 6ｧ 閨 ｸ704apple 閨0ｹ fi ｹ apple000306apple ｹ0 fiapple080ｸ fi ﾇ ｷ ｧ ｧ ｸ7 03a ﾇ 2 O apple080ｸ ｧ9ｨB080ｸ apple 046ｦ ｧ9 00apple6ｧ904090ｹ ｧ8030ｷ ｹ0 ﾞ08. ﾇ 0ｸ 閨 ｸ7-00apple ｧ fi apple080ｸ7 0ｸ7apple ｸ70ｹ ｧ90ｹ0 0ｸ702086ｦ00ｹ ｧ apple ｯ 000ｸ703006ｧ9 0ｹ a + - ﾇ 2 O ｦ00ｹ0 0004apple 閨07 040ｷ , ｧ apple0802 閨 閨 閨 ｸ ﾞ ﾞ 19,20. ﾇ 6ｦ ｸ7 apple ｦ0 036ｧ9apple080ｸ70ｹ ｸ ｸ70ｹ ｦ00ｹ0, 0000 apple0802 閨 ｸ ｸ , apple086ｧ9000ｹ ｦ ｦ ｸ7 030ｸ ｦ0 04apple ｧ80ｹ0 066ｧ ｹ0 (GFR), 08applefi ｸ ｧ ｦ apple fi a + - ﾇ 2 O 21. 6ﾑ8apple6ｧ904090ｹ0 apple ｧ fi apple 046ｦ 閨04080ｸ ｷ300 閨07 00apple6ｧ9apple ｸ ｦ0 apple00apple0206 6ｧ9-080ｸ7 (ANP) apple ｸ707 fi000ｷ30ｹ apple ｹ0 apple080ｸ ｧ9ｨB ﾞ apple 046ｦ ｸ70ｹ0, fiapple0ｷ30ｹ0 006ｧ ｸ ｧ ｸ ｹ0 020ｷ ｧ90ｷ ﾇ 0ｸ7apple ｸ ｧ9 apple080ｸ ｧ apple apple fi 020ｷ ｸ70ｸ ｸ ｷ ｷ ｧ90ｷ307 24, 09 0ｸ 閨0709 apple ｷ3096ｧ8 apple ｷ ｸ applefi apple fi apple08026ｧ907000ｹ0, C apple030ｷ302000ｹ10709 (CRP), apple080ｸ7 apple ｸ ｧ ｸ7apple apple ｧ9 apple080ｸ7 00apple6ｧ904090ｹ ｧ apple apple fi 020ｷ ｧ90ｷ ｸ70ｸ ｸ ｷ 閨 ,26, apple ｦ ｧ8 0ｸ ｸ703096ｧ apple 02fi03080ｸ ｸ ｧ9 020ｷ ｧ90ｷ apple ｷ303006ｧ ｸ70404 閨 ﾞ ｸ 閨07 00apple6ｧ9apple00 CRP apple ｧ90709, fi0709 apple080ｸ7 apple applefi apple fi apple 6ｧ9ｨB fi fi 02090ｹ ｸ702fiｨB090ｹ0, 閨 閨 ｹ0 CRP apple fi, fiapple0ｷ30ｹ apple ｧ8 046ｦ ｧ ｹ0, 閨04080ｸ ｧ80ｹ ｸ7 apple 閨02030ｷ304090ｹ ｸ7 fi ｸ7 (TNF- ) ｷ30ｹ fi0ｹ0 fi ｸ70ｹ0 apple 046ｦ ｸ70ｹ apple6ｧ9apple ｹ0 006ｧ ｷ300 閨07, ｦ ｦ ｷ307 00apple06apple 陦0ｷ ｹ0 CRP ﾞ ｦﾐ 06 6ｧ 閨 apple 03080ｸ ｨB 閨0409

3 13100 A ｧ8 Yapple 閨 , 14, ｸ7 080ｸ ｦ 閨080ｹ ｧ8 0ｸ7apple 閨 , 08086ｦ 閨 apple ｧ9 apple applefi 02 6ｦ008 apple ｧ apple ｸ 閨07 apple080ｸ7 apple ｦ0080ｸ707 fi ｸ7apple ｸ ｧ9 apple ｧ9 006ｧ apple ｹ ﾞ08, fi02 07 apple 03080ｸ ｨB apple ｧ ｧ9, ｧ9ｨB apple03fi0ｷ303090ｹ0 ﾞ ﾑ8apple6ｧ904090ｹ0 apple ｧ fi0206 0ｸ7apple 閨 ｹ0 0ｸ7apple ｸ ｧ9 0ｹ ｸ7020ｷ ｸ7036ｧ fi0206 0ｸ702fi 040ｸ70700apple fi fi04080ｸ70ｹ033. 6ﾑ809ｦﾐ09ｦ 036ｾ46ﾑ8ｦﾐ6ｾ4 ｦ fi 006ｧ ｦ apple080ｸ7 020ｸ7-036ｧ90ｷ30ｹ0 00apple ｦ ｸ70ｹ0 apple 046ｦ ｸ70ｹ ﾞ ｧ ｦ ｸ7 020ｸ ｦ ｹ0 fi ｸ7 6ｧ ｹ0, 6ｦ ｹ ｧ80ｹ0 apple ｧ80ｹ ｸ7-0407fi ｹ0, apple 閨0ｹ ｹ0 apple 閨07080ｸ ｸ 閨0ｹ034. ﾇ ｧ8 0ｸ ｸ ｧ ｸ7apple ｧ ｧ9ｨB apple fi ｧ8 apple 040ｸ ｧ9 35. ﾇ ｧ8 0ｸ ｸ703096ｧ ｧ9ｨB ｹ0 6ｦ ｹ ｸ ｸ70ｹ0, apple ｸ apple ｧ ｸ ｧ8 0ｸ ｸ703096ｧ9 00 ｨB6ｧ 閨 ｸ ｧ8 0ｸ7apple ｧ ｹ ｹ ｧ9 0ｹ0. ｦ apple 03 apple07070ｷ3 00apple ｧ907080ｸ ｧ907 0ｸ ｹ0 040ｸ ｧ80ｹ ｧ80ｹ0 0700apple ｹ0, ｸ ｧ9 060ｷ ｷ307 34,36. O06 apple ｧ ｧ9 apple080ｸ apple ｦ ｧ ｸ7apple ｧ9, 09 08apple086ｧ ｧ ｸ ｧ8 apple08 fi ｸ76ｧ8 (remodeling) 02090ｹ ｹ ｧ9 0ｹ0, ｧ ｧ9 020ｷ307 apple 046ｦ ｷ307, 09 08apple086ｧ9 0ｸ ｧ ｧ ｹ ｸ7apple ｧ ｹ ｹ ｧ9 0ｹ023, 09 6ｦ ｷ ｸ ｧ90ｷ ｷ ｸ ｸ ｷ307, 09 08apple086ｧ9 00apple ｧ ｧ applefiapple020ｷ ｦ ｸ ｸ70ｹ ｦ 閨0ｹ ｹ ｧ80ｹ fi ｹ ｹ ｧ ｹ ｸ ｧ9080ｸ7 apple080ｸ7 apple ｧ ｸ707 閨 apple ｧ ｸ ｧ ｸ ｧ ﾑ80202fi0ｹ0 fi000ｷ30ｹ0 applefi , ｹ0 0ｸ7apple ｸ apple ｧ , 08086ｦ ｸ7020ｷ ｸ7036ｧ ｧ9- ｨB ｸ 閨 ｧ907 0ｸ ｹ apple ｧ90ｷ fi04080ｸ70ｹ ｹ0 ﾞ08 apple ｦ ｧ9. ﾇ 6ｦ ｹ0 040ｸ ｧ80ｹ0 ﾞ09, 閨04080ｸ7 6ｦ ｹ ｹ0 apple6ｧ ｹ0 020ｷ307 04apple ｸ ｸ apple06 閨04000ｷ307 (040809) ｦ ｹ ｧ80ｹ ｧ80ｹ0 6ｧ ｹ0 (RPF) ｹ ｷ304000ｷ ｧ8 apple6ｧ apple ｧ8, ｷ304000ｷ apple06 閨04000ｷ307 (04 ﾒ09). ﾞapple0802 閨 ｸ ｧ ｦ ｸ7 GFR 046ｦ000080ｷ ｦ0apple08 [GFR=KFx( ﾒ09)] 40. 6ﾑ8apple6ｧ904090ｹ0 09 0ｸ 閨 ｸ70902 閨 ｷ30409 Na apple0ｷ3 040ｷ , ｧ 閨04080ｸ ｹ0 04apple ｷ ｧ80ｹ apple6ｧ9 0ｹ apple0ｸ702076ｧ ｧ9, ｦ ｸ7 GFR ｧ ｦ003080ｸ70ｹ apple apple 0307, 08 6ｧ ｧ ｧ8, 04apple ｧ8 0ｸ7apple ｧ , 0ｸ 閨0709 閨 ｸ7020ｷ ｧ907090ｹ 閨0ｹ 閨0ｹ0 apple080ｸ7 apple ｦ ｹ ｹ ｸ7 Bowman, 00apple6ｧ ｸ7 apple apple ｦ0 020ｷ307 04apple ｸ ｷ ｸ ｧ9080ｸ7, 03 鐶pple020ｸ ｹ ｧ80ｹ ｹ ｸ 閨0709 閨 ｸ ｦ0 0ｸ ｦ0 apple (Transforming Growth Factor-TGF-6 5) 21,42. ﾞapple0802 閨 ｷ307 apple - 03 apple07070ｷ3 006ｧ apple ｧ8030ｸ ｸ7-020ｷ ｸ7036ｧ9, 09 08apple086ｧ ｸ707 0ｸ7 0400fi ｹ ｹ0 apple080ｸ7 apple ｧ ｧ802090ｹ0, 08086ｦ0 040ｸ7070ｸ7apple apple fi apple 046ｦ ｷ307, ｦ ｧ ｧ8 04apple ｧ8030ｸ , ｸ 閨 ｧ ｧ80ｹ ｹ0 020ｷ307 02fi000ｷ307 0ｸ ﾇ ﾞ08 fi000ｷ30ｹ0 apple ｧ ｹ , 08086ｦ0 apple ｧ fi apple 046ｦ 閨04080ｸ ｸ7-0407fi apple applefi 02080ｸ70ｹ ｧ90ｹ0 0ｸ7apple ｦ00ｹ044. ｦ 閨03080ｹ0 apple03 鐶pple ｧ9 fi ｸ7apple ｧ ｧ9ｨB080ｸ 閨0ｹ ｷ ｧ ｸ7 080ｸ ｦ ｯ 00apple apple ｧ ｸ731, 0000 apple0802 閨 ｧ8030ｷ ｸ7apple ｸ ｧ9 0ｹ0. ﾞ03ｦ ｦﾐ096ﾑ8ｦ 0309ｦﾐ6ｾ4 ﾇ ﾇ apple000ｸ ｧ8 apple 閨 ｹ0 ﾞ ｸ ｦ0 040ｸ707 03fi00080ｸ7 apple03 鐶pple apple 閨0ｹ apple ｹ0. 6ｾ46ｦ000080ｷ ｹ ｸ7030ｸ707026ｧ ｹ ｧ9000ｹ ｹ0 NCEP-ATP III ｧ ｸ7 0203fiapple080ｸ7 ｨB0ｷ36ｧ80ｹ0 006ｧ ｧ80ｹ ｧ9 0ｹ apple ｷ307 00apple06apple ｸ ｦ0 040ｸ707 03fi00080ｸ745. ﾇ apple ｸ70ｹ0, 09 0ｸ 閨 ｸ ｧ fi020902, 08 apple fi0ｹ ｸ ｹ apple08080ｸ7096ｧ fi apple076ｧ ｹ0 08 6ｧ fi ｧ9ｨB fi ｧ90ｷ ｹ0 ﾞ09 fi ｧ90ｷ ｷ307 fi04000ｷ307 6ｧ ｸ ｦ0 020ｷ ｸ ｷ apple080ｸ7 6ｧ ｸ7applefi apple ｧ8 090ｷ3096ｧ8 46. ﾇ apple ｸ70ｹ0, ｧ fi ｸ702fi 閨 ｧ ｧ8, 03000ｷ303006ｧ apple03 閨0807 apple fi0ｹ ｸ fi0ｹ0 0203fiapple080ｹ ｧ90ｷ304090ｹ ｹ0 ﾞ ｾ ｧ ｸ70409 applefi 閨02000ｹ ｧ90ｹ0, 06 apple fi

4 13A ｧ8 Yapple 閨 , 14, apple kg 040ｷ ｦ ｸ70ｹ0 0ｸ7apple6ｧ ｧ9-0ｷ ｹ0 040ｸ ｧ80ｹ ｧ80ｹ0 apple6ｧ ｹ mmhg fi apple ｸ70ｹ ｧ90ｷ ﾞ ｦ00ｹ0 apple 046ｦ ｸ70ｹ ｸ7 06 apple6ｧ904020ｷ ｧ90ｷ ｸ o ｦ0 fi ｸ7, 02090ｹ ｧ80ｹ0 apple ｧ80ｹ ｸ7apple ｧ ｹ0 0ｸ7apple ｧ9 0ｹ ｹ ｹ ｧ9 0ｹ049. ﾇ apple ｸ70ｹ0 00apple ｧ apple ｸ ｧ ｸ707 0ｸ7 0400fi ｹ0 6ｧ ｹ ｸ 閨07090ｹ0 080ｸ ｧ80ｹ fi ｹ0. 6ﾑ86ｧ ｧ ｸ ｧ ｧ8 020ｷ ｸ fi apple0806fi020902, apple0804fi ｦ apple apple ｧ fi fi ｧ90ｷ ｸ ｸ70ｹ ｧ ｧ ｸ750. ﾇ 0ｸ 閨 ｸ ｧ fi ｧ9ｨB ｧ90ｷ ｹ0 ﾞ applefi ｦ0apple ｧ apple ｹ ｸ70ｹ apple080ｸ ｦ ｧ9ｨB080ｸ fi ﾞ09 applefi 0ｸ ｦ00ｹ0 apple080ｸ ｸ ｧ8 ｨB0ｷ36ｧ8 51. O 閨0ｹ ｧ ｹ0 fiapple0ｷ30ｹ0 apple08 6ｧ , ｦ , 09036ｧ jogging 006ｧ ｦ apple 閨 fi ｧ90ｷ ｹ0 ﾞ09. O ｧ9 apple080ｸ ｧ9ｨB080ｸ ｧ90ｷ ｹ0 ﾞ09 006ｧ ｧ90ｷ ｹ0 040ｸ700apple ｧ80ｹ fi ｹ0 ( ｷ ｹ apple ｧ907090ｹ0) ｧ8 ( 6ｦ ｸ apple080ｸ7 apple ｦ ｷ ｧ90ｷ307, fiapple0ｷ30ｹ0 apple ｧ ﾑ8) 閨 apple 03 - apple07070ｷ apple ｸ707 02fi ｧ ｷ307 apple080ｸ ｧ9ｨB ｧ90ｷ ｸ ｸ70ｹ0, fiapple0ｷ30ｹ apple080ｸ ｧ90709 閨04080ｸ707 閨 ｧ applefi ｹ0 fi apple6ｧ ｸ7 apple ｦ ｸ ｹ ﾞ ｹ0 apple 040ｸ ｧ9 0ｹ0. 08apple ｸ707 0ｸ702086ｧ9 apple080ｸ7 0ｸ7apple ｧ9ｨB080ｸ707 fi ﾞ09 00apple ｧ ｷ303006ｧ apple ｸ70ｹ0, applefi ｷ ｹ053, 閨 apple ｧ ｧ ｧ90ｷ3046ｧ ｹ apple08080ｸ7096ｧ ｸ ｹ0, 00apple ｹ0 0ｸ702086ｦ00ｹ0 apple080ｸ ｷ303086ｦ ﾞ ｹ0 apple 040ｸ ｧ9 0ｹ0 0ｷ30ｹ ｸ7 6ｧ ﾇ ｸ ｧ apple ｹ0 ﾞ08 apple03 鐶pple ｧ ｹ0 apple 閨 ｹ ｹ ｷ ｸ apple ｷ307 apple080ｸ ｧ9ｨB0006 閨07 apple - 046ｦ ﾇ 040ｸ 閨 fi07 046ｦ000080ｷ fi 02080ｸ ｦ0 040ｸ707 03fi00080ｸ7 006ｧ ｸ7076ｦ0apple ｧ ｹ ｸ7036ｧ ｸ fi ｧ ｦ0apple080ｸ ﾞ ｧ9 fi apple ｧ ｧ90ｷ ｹ0 ﾞ ｦ00ｹ0 閨 ｸ apple 閨 ｦ 08 00apple06030ｸ fi fi ｯ 0ｸ702086ｦ00ｹ0 006ｧ /80 mmhg 0906 apple ｧ9 applefi 00apple06apple 閨0ｹ ｹ apple ｹ apple6ｧ902000ｸ7016ｧ ｸ7, 0400 apple fi apple07-070ｷ3 applefi 65% 020ｷ307 02fi000ｷ307 apple ｧ ｧ ｦ ｸ ｷ ﾞ 閨 ｸ7apple ｸ7-020ｷ ｸ7036ｧ fi ｸ702fi /75 mmhg 55. ｦ apple080ｸ ｧ902070ｸ ｧ ｧ90ｹ ｸ apple ｦ0 0007ｨB6ｦ000080ｸ ｹ ｧ907090ｹ0 ( -096ﾑ8 ﾞ), ｧ90ｹ0 020ｷ307 ﾞｦ -1 0ｸ7apple 閨0ｷ ｹ0 AG-ｦﾐｦﾐ, ｧ90ｹ0 020ｷ ｦ0030ｷ ｧ9080ｸ 閨0ｹ0 fi ｹ ｸ O06-096ﾑ8 ﾞ 03000ｷ303086ｦ ｧ80ｹ0, 08086ｦ ｸ707 02fi fi 026ｧ907 0ｸ70708, fi 閨 ｹ ｧ80ｹ ｹ0. ﾇ 閨0209 HOPE 6ｧ ｸ7026ｧ8 apple080ｸ7 apple 陦 fi apple036ｧ ｧ90ｷ ｸ70407fi ｷ ｷ307, 020ｷ ｷ ｷ apple ｧ90ｷ ｸ ｦ ｦ007080ｸ7, 閨04080ｸ ｧ90ｷ304090ｹ ｹ0 0ｸ7apple ｧ9 0ｹ ｹ ｹ ｧ9 0ｹ057, ｹ0 00apple6ｧ904090ｹ 閨 ｹ apple ｹ 閨04080ｸ ｧ90ｷ304090ｹ ｹ ｸ7020ｷ ｸ7036ｧ9 0ｹ ｦ00ｹ0, apple fi0ｹ0 fi ｧ ｧ ｸ fi apple0802 閨 ｷ ｹ0 ﾞ ｾ ｧ apple0802 閨 ｧ ｧ ｧ apple0208apple036ｧ903090ｹ ｦ00ｹ059. 6ﾑ8apple6ｧ904090ｹ ﾑ8 ﾞ 040ｸ ｸ ｧ90ｷ ｸ ｦ0 020ｷ307 0ｸ ｷ307, apple 02fi03080ｸ ｧ90ｷ ｸ ｸ ｦ ｸ7 0306apple ｦ0 apple ｧ ｷ307 apple 046ｦ ｷ307, apple 閨04080ｸ7 6ｦ ｹ ｸ7 03fi00080ｸ7 020ｷ ( 6ｦ ｹ ｧ80ｹ ｧ80ｹ ｧ ｦ ｧ ｹ ｸ7036ｧ907090ｹ apple080303fi ｹ ｹ ｸ702fiｨB090ｹ0 applefi 02080ｸ70ｹ ｦ00ｹ0) 60. 6ﾑ8apple0006 6ｧ8 fi000ｷ30ｹ ﾑ8 ﾞ 0007 閨04080ｸ apple06030ｸ fi apple0802 閨 fi ｧ90ｷ ｹ0 ﾞ09, ｸ707 0ｸ7 0400fi0ｹ ｸ70ｹ 閨0ｹ0 fi ｹ ｸ ( ｨB6ｧ9 000ｹ0 12,5-25 mg 閨03 6ｧ ｸ ｧ ｧ8 0700apple ), apple ｦ apple06036ｦ ｹ 閨 閨0ｹ ｸ70ｹ0, fiapple0ｷ30ｹ ｸ ｧ ｦ ｷ apple06 6ｧ90ｷ307, 03000ｷ303006ｧ apple ｧ ｹ ｦ ｹ0 ﾞ09. ﾒ ｸ ｧ ｸ70ｹ ｧ90ｹ0 020ｷ307 AT-1 0ｸ7apple 閨0ｷ ｹ0 AG-II, 08086ｦ 閨04080ｸ ｸ apple 閨 fi ｸ7apple ｧ ｹ ｹ ｧ9 0ｹ 閨 ｹ ｧ80ｹ ｹ0, ｸ apple ﾞ09, 0906 ｯ 0ｸ702fi apple ｦ0080ｸ707 applefi fi ｧ90ｹ0 020ｷ ｦ0030ｷ ｧ9080ｸ , 06 apple fi0206 fi fi ｧ ｧ ｸ7apple fi apple0802 閨 ｸ ｷ ｨB6ｧ9 09, apple06apple03 閨 ｧ90ｷ ｸ ｧ ｸ7036ｧ apple ｦ ｸ7 6ｾ4036ｾ ｧ ｧ ｷ ｧ

5 13102 A ｧ8 Yapple 閨 , 14, ｹ ｹ ｧ90ｹ0 020ｷ ｦ0030ｷ ｧ9-080ｸ7 apple080ｸ7 00apple ｦ ｸ ｸ ｸ ｸ70ｹ0-096ﾑ8 ﾞ ｸ ﾞ09, ｧ ｸ7 閨 fi ｸ70ｹ fi 02090ｹ ｸ702fiｨB090ｹ ｷ apple06 6ｧ90ｷ ｾ apple6ｧ ｧ ｸ70ｹ fi 046ｦ applefi ｹ0 066ｧ ｦ 閨0209 HOT applefi ｧ9 陦 fi apple6ｧ90709 閨 apple ｸ ｧ , FACET (040ｸ ｧ 閨 apple036ｧ903090ｹ0 閨 apple6ｧ907090ｹ0) 陦 fi ｧ90ｹ0 020ｷ ｦ0030ｷ ｧ9080ｸ apple 閨03080ｸ707 00apple 03026ｧ8 apple ｧ9 applefi ｧ9 040ｸ O ｧ90ｹ0 020ｷ ｸ7apple 閨0ｷ ｧ ｸ 閨 apple ｦ apple , 02 08apple086ｧ9 046ｦ000080ｷ apple 03 apple07070ｷ ｸ707 閨 ｸ70ｹ0 apple 046ｦ ｸ70ｹ0. ﾇ 閨0209 UKPDS 陦 fi fi ｧ ｧ9 06 apple 閨 apple0208apple036ｧ90309 fi apple ｷ30ｹ0 fi000ｷ30ｹ0 03 apple03 鐶pple apple ｦ fi090ｷ3 020ｷ307 apple ｸ70ｹ0, 08086ｦ fi0ｹ ｸ7 fi0206 apple ｦ 閨0ｹ ｸ ｦ0 020ｷ apple06 6ｧ90ｷ ｸ ｸ ｧ ｸ7036ｧ90709, 閨 ｧ9 fi ｧ9ｨB ｦ ｸ7 040ｷ ｦ ｸ70ｹ 閨 apple ｧ8 090ｷ3096ｧ8 006ｧ apple 03 6ｧ ｧ8 090ｷ3-096ｧ8. ﾇ 04036ｧ ｧ907090ｹ ｨB fi 02090ｹ ｸ702fiｨB090ｹ ｷ apple06 6ｧ90ｷ307 (00006ｧ90ｷ ｸ ｧ80ｹ0) ﾞ09 1,68. 6ﾑ809ｦﾐ ﾌ 罍ﾌ6ｾ4 6ｾ40ｸ700apple applefi ｧ fi ﾞ08 020ｷ307 apple 046ｦ ｷ ｧ9ｨB ｧ ｸ ｸ ｧ8 apple ｧ9, ｧ9 apple080ｸ7 0000apple03 閨 apple 閨 ｹ0 006ｧ apple apple03086ｧ ｧ fi00 0ｸ7applefi ｦ ﾑ8apple0006 6ｧ8 fi000ｷ30ｹ apple 閨0ｹ0 00apple ｹ ｹ ｦ fi , fiapple0ｷ30ｹ ｧ9, 02036ｧ apple ｧ8 09 apple030804apple apple06046ｧ80ｹ ｹ0. ｦﾐ 06 6ｧ ｦ apple03 鐶pple ｧ ｧ ｸ7 0203fiapple080ｸ7 ｨB0ｷ36ｧ80ｹ0, 08086ｦ0 apple ｧ 閨 ｧ90308, fi fi ｧ90ｷ ｹ0 ﾞ ｧ9 ｨB0ｷ36ｧ fi ｸ707 02fi fi apple ｧ ｸ709006ｧ9 0ｹ0. 6ｾ40ｸ700apple ｷ ｧ8 6 5 閨 ｧ apple6ｧ902000ｸ ｸ7 00apple06030ｸ ｦ0 apple 閨 ｹ0 apple 閨03080ｸ , 006ｧ ｸ ｧ apple , 006ｧ ｹ0 apple 040ｸ ｧ9 0ｹ0. SUMMARY Mavromatidis K, Kalogiannidou E. The hypertension in metabolic syndrome. Arterial Hypertension 2005; 14: Metabolic syndrome is characterized by insulin resistance, arterial hypertension, atherogenic hyperlipidemia, thombogenic predisposition and central o- besity. Epidemiological studies, which have been done at the last decade, found that there is a correlation between obesity and hypertension. So, the danger of arterial hypertension in obesity patients, especially those who have central fat distribution, is three fold in relation to those who have normal body weight. In this review we analyze the causes and mechanisms of hypertension, which are more than one (increase activity of sympathetic nervous system, increase activity of renin-angiotensin-aldosterone axis, reduction of vasodilator substances such as NO, and increase of the total body sodium and water etc). Also we analyze the injuries in organ-target such as kidneys, heart and e- yes and the therapeutic intervention (antihypertensive drugs, treatment against obesity ect). ｦﾌｦﾐｦﾌ ｦﾐ ﾌ 縺06 ﾞ02ｦﾐ ﾞ 1. Giugliano D, De Rosa N, Di Maro G, et al. Metformin improves glucose, lipid metabolism, and reduces blood pressure in hypertensive, obese women. Diabetes Care 1993; 16(10): Doll S, Paccaud F, Bovet P, Burnier M, Wietlisbach V. Body mass index, abdominal adiposity and blood pressure: consistency of their association across developing and developed countries. Int J Obes Relat Metab Disord 2002; 26: Rexrode KM, Manson JE, Hennekens CH. Obesity and cardiovascular disease. Curr Opin Cardiol 1996; 1(5): Garrison RJ, Kannel WB, Stokes J 3rd, Castelli WP. Incidence and precursors of hypertension in young adults: the Framingham Off-spring Study. Prev Med 1987; 16: Masuo K, Mikami H, Ogihara T, Tuck ML. Weight gaininduced blood pressure elevation. Hypertension 2000; 35(5): Plut C, Ribiere C, Giudicelli Y, Dausse JP. Gender differences in hypothalamic tyrosine hydroxylase and alpha(2)-adrenoceptor subtype gene expression in cafeteria diet-induced hypertension and consequences of neonatal androgenization. J Pharmacol Exp Ther 2002; 302: Wofford MR, Anderson DC Jr, Brown CA, Jones DW, Miller ME, Hall JE. Antihypertensive effect of alpha- and betaadrenergic blockade in obese and lean hypertensive subjects. Am J Hypertens 2001; 14 (7 Pt 1): Landsberg L. Pathophysiology of obesity-related hyper-ten-

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