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目的研究非糖尿病人群中不同糖耐量状态组颈动脉内中膜厚度(intimalmedialthickness,IMT)的差异性,并且分析口服糖耐量试验(OGTT)中四时点血糖水平及各种脂代谢指标与IMT的相关关系。方法收集11名正常人、69例新近由OGTT试验诊断的糖调节受损(IGR)者〔其中包括28例OGTT30min和60min血糖未升高(<11.1mmol/L)(NPG/IGR)者和41例30min或(和)60min血糖升高(≥11.1mmol/L)(IPG/IGR)者〕的临床资料:包括年龄、性别、身高、体重、血压、体重指数(BMI),以及OGTT四时点(0,30,60和120min)血糖、空腹血脂〔包括甘油三酯,总胆固醇(TC),高、低密度脂蛋白胆固醇(HDLC、LDLC),载脂蛋白A、B(ApoA、ApoB)〕等生化指标,计算0～60min及0～120min血糖时间曲线下面积(AUC060和AUC0120),并以彩色DopplerB型超声测量受试者的颈动脉IMT。结果(1)IMT值在IGR各组(NPG/IGR组和IPG/IGR组)均显著高于正常对照组(NGT组,P<0.05和P<0.01),IMT值在前两组之间差异并无统计学意义;(2)相关性研究显示,在所有非糖尿病个体中,IMT值与年龄、TC、LDLC、ApoB及OGTT120min血糖值均存在显著正相关(r值分别为0.260、0.307、0.341、0.290、0.451,P<0.05或P<0.01);(3)多元回归分析显示,虽然LDLC和OGTT120min血糖值均为颈动脉IMT的独立相关因素,但LDLC水平显示出最强的统计学相关性(P<0.05)。结论在上海地区非糖尿病人群中,OGTT120min血糖和LDLC值为早期动脉硬化的独立危险因素,而空腹血糖水平与其发生并无显著相关性。在IGR人群中,OGTT30min或(和)60min血糖水平升高并未显示有加重动脉粥样硬化的趋势。
Objective To investigate the difference of intimal medial intima-media thickness (IMT) between different glucose tolerance groups in non-diabetic patients and to analyze the changes of blood glucose level and the indexes of lipid metabolism in oral glucose tolerance test (OGTT) relationship. METHODS: Eleven normal individuals, 69 newly diagnosed IGRs (including 28 with OGTT at 30 min and no elevated blood glucose at 60 min (NPG / IGR), and 41 Clinical data including age, sex, height, weight, blood pressure, body mass index (BMI), and OGTT at four time points in patients with elevated blood glucose (≥11.1 mmol / L) (Including triglycerides, total cholesterol (TC), high and low density lipoprotein cholesterol (HDLC), apolipoprotein A, B (ApoA, ApoB) (AUC060 and AUC0120) were calculated. The carotid IMT of the subjects was measured by color Doppler B-mode ultrasound. Results (1) IMT value in IGR group (NPG / IGR group and IPG / IGR group) were significantly higher than that in normal control group (NGT group, P <0.05 and P <0.01) (2) The correlation study showed that there was a significant positive correlation between IMT value and blood glucose level of age, TC, LDLC, ApoB and OGTT120min in all non-diabetic subjects (r values were 0.260,0.307,0.341 , 0.290,0.451, P <0.05 or P <0.01). (3) Multivariate regression analysis showed that, although the blood glucose of LDLC and OGTT120min were independently correlated with carotid IMT, LDLC level showed the strongest statistical correlation (P <0.05). Conclusion In Shanghai non-diabetic population, the blood glucose and LDLC values of OGTT120min are independent risk factors for early arteriosclerosis. However, there is no significant correlation between fasting blood glucose level and its occurrence. In the IGR population, elevated blood glucose levels at 30 min or 60 min of OGTT did not show a tendency to aggravate atherosclerosis.