论文部分内容阅读
目的探讨单纯糖耐量受损(I-IGT)者的内皮功能改变和危险因素的特点。方法按2005年国际糖尿病联盟肥胖标准分肥胖和非肥胖组,选择I-IGT 83例(肥胖即D2亚组42例;非肥胖即D1亚组41例),与糖耐量正常者142例(肥胖即N2亚组67例;非肥胖即N1亚组75例)作比较,做口服葡萄糖耐量试验及胰岛素释放试验,检测0min、10min、20min、30min、60min、120min血糖、免疫活性胰岛素,同时检测空腹血脂、游离脂肪酸、脂联素、超敏C反应蛋白(hs-CRP)、血清内皮素(SET),留取晨尿测定尿内皮素(UET)与尿微量白蛋白(U-MA),记录糖尿病家族史并观察血压、身高和体重,测定肱动脉休息时、加压及服用硝酸甘油后的内径变化。结果校正性别、年龄后I-IGT与糖耐量正常者、D2亚组与N2亚组以及D1亚组与N1亚组比较,U-MA、hs-CRP、UET和SET均有上升而内皮依赖性血管舒张功能和内皮非依赖性血管舒张功能下降有明显改变(P<0.05或P<0.01),D2亚组与D1亚组比较hs-CRP有显著改变(P<0.01);多元回归分析显示,以内皮指标为因变量能进入方程的有糖尿病家族史、肥胖、血压、脂代谢、血糖及胰岛分泌功能等指标。结论 I-IGT非肥胖者和肥胖者主要表现为大血管混合微血管内皮改变,肥胖者大血管内皮改变较为严重;内皮功能改变的危险因素与糖尿病家族史外,还与肥胖、血压增高、脂代谢紊乱、血糖增高及胰岛功能的改变等代谢性因素密切相关。
Objective To investigate the changes of endothelial function and the risk factors in patients with simple impaired glucose tolerance (I-IGT). Methods Totally 83 I-IGT patients (42 obese patients in D2 subgroup, 41 non-obese patients in D1 subgroup) were divided into obesity group and non-obese group according to the 2005 International Diabetes Federation obesity criteria. 142 obesity Namely N2 subgroup of 67 cases; non-obesity or N1 subgroup of 75 cases) for oral glucose tolerance test and insulin release test, detect 0min, 10min, 20min, 30min, 60min, 120min blood glucose, immune active insulin, Serum lipids, free fatty acids, adiponectin, hs-CRP, SET, urine UA and U-MA were measured before taking morning urine, Family history of diabetes mellitus and blood pressure, height and weight were measured, and the brachial artery at rest, pressure and after taking nitroglycerin inner diameter changes. RESULTS: U-MA, hs-CRP, UET and SET were both up-regulated and endothelium-dependent in terms of gender, age, IGT and glucose tolerance, D2 subgroup and N2 subgroup, (P <0.05 or P <0.01). There was a significant change in hs-CRP between D2 subgroup and D1 subgroup (P <0.01). Multivariate regression analysis showed that hs- Endothelial index as a dependent variable can enter the equation with diabetes family history, obesity, blood pressure, lipid metabolism, blood glucose and pancreatic islet secretion and other indicators. Conclusion The non-obesity and obesity in I-IGT are mainly manifested as macrovascular mixed microvascular endothelium changes, and the changes of macrovascular endothelial in obese patients are more serious. The risk factors of endothelial dysfunction and family history of diabetes mellitus are also related to obesity, elevated blood pressure, Disorders, hyperglycemia and changes in islet function and other metabolic factors are closely related.