CAJ | 학술논문

目的观察糖耐量减低(IGT)、2型糖尿病(DM)患者的内皮依赖性血管舒张功能(EDF)及血清血管内皮生长因子(VEGF)的变化.方法 30例IGT患者、30例2型DM患者及33例正常对照者(NGT),空腹静脉血测定葡萄糖(FPG)、胰岛素(FINS)、超氧化歧化酶(SOD)、丙二醛(MDA)、VEGF,并行75 g口服葡萄糖耐量试验(OGTT).采用高分辨率血管外彩超测定肱动脉的血管内径,以肱动脉反应性充血前后血管内径变化百分比反映EDF.结果 (1)IGT组、DM组的EDF较NGT组显著下降(P均＜0.01),DM组较IGT组更低(P＜0.01).(2)IGT组、DM组的SOD较NGT组显著下降(P均＜0.01),而MDA显著上升(P均＜0.01).DM组与IGT组比较SOD显著下降(P＜0.01),MDA显著上升(P＜0.01).(3)VEGF在NGT、IGT、DM组逐渐上升,两两比较差异均有统计学意义(P均＜0.01).(4)3因素逐步回归分析显示:EDF与SOD明显正相关(r=0.418,P＜0.01,n=93),与HOMA-IR、VEGF明显负相关(r=-0.553、-0.221,P均＜0.01,n=93);而VEGF与SOD明显负相关(r=-0.552,P＜0.01,n=93).结论 EDF的损害在IGT阶段即可出现,而在DM患者中损害更为严重.胰岛素抵抗、VEGF、SOD、MDA与EDF的损害密切相关.
목적 관찰당내량감저(IGT)、2형당뇨병(DM)환자적내피의뢰성혈관서장공능(EDF)급혈청혈관내피생장인자(VEGF)적변화.방법 30례IGT환자、30례2형DM환자급33례정상대조자(NGT),공복정맥혈측정포도당(FPG)、이도소(FINS)、초양화기화매(SOD)、병이철(MDA)、VEGF,병행75 g구복포도당내량시험(OGTT).채용고분변솔혈관외채초측정굉동맥적혈관내경,이굉동맥반응성충혈전후혈관내경변화백분비반영EDF.결과 (1)IGT조、DM조적EDF교NGT조현저하강(P균＜0.01),DM조교IGT조경저(P＜0.01).(2)IGT조、DM조적SOD교NGT조현저하강(P균＜0.01),이MDA현저상승(P균＜0.01).DM조여IGT조비교SOD현저하강(P＜0.01),MDA현저상승(P＜0.01).(3)VEGF재NGT、IGT、DM조축점상승,량량비교차이균유통계학의의(P균＜0.01).(4)3인소축보회귀분석현시:EDF여SOD명현정상관(r=0.418,P＜0.01,n=93),여HOMA-IR、VEGF명현부상관(r=-0.553、-0.221,P균＜0.01,n=93);이VEGF여SOD명현부상관(r=-0.552,P＜0.01,n=93).결론 EDF적손해재IGT계단즉가출현,이재DM환자중손해경위엄중.이도소저항、VEGF、SOD、MDA여EDF적손해밀절상관.
Objective To observe the changes of the endothelium-dependent vasodilatation(EDF)and serum vascular endothelial growth factor(VEGF)in the patients with impaired glucose tolerance(IGT)and type 2 diabetes mellitus(DM).Methods 30 IGT patients,30 type 2 DM patients and 33 normal subjects were divided into3 groups. Fasting glucose(FPG),fasting insulin(FINS),serum superoxide dismutase(SOD),maleie. dialdehyde(MDA)and VEGF were measured after 12 hours overnight fast. Oral 75g glucose tolerance test(OGTT)was performed. The inner diameter of braehial artery was assessed by a high resolution ultrasound system before and after reactive hyperemia. EDF was calculated as the percent change in brachial artery diameter 1 minute after reactive hyperemia compared with baseline. Results In the IGT group and DM group, EDF was significantly lower than that in NGT group(both P＜0.01),and EDF in the DM group was significantly lower than that in the IGT group(P＜0.01).SOD in the IGT group and DM group were significantly lower than that in the NGT group(both P＜0.01),but MDA in reverse(both P＜0.01).Compared with the IGT group, SOD in DM group was significantly lower(P＜0.01),but MDA was significantly higher(P＜0.01).VEGF was progressively increased in the NGT,IGT, DM groups. The difference between the two groups was significant(both P＜0.01).Stepwise regression analysis showed that EDF was positively related to SOD(r=0.418,P＜0.01,n=93),and negatively related to HOMA-IR and VEGF(r=-0.553,-0.221,both P＜0.01,n=93).VEGF was negatively related to SOD(r=-0.552,P＜0.01,n=93).Conclusion EDF is impaired in IGT patients while the impairment in DM patients becomes more marked. Insulin resistance, VEGF,SOD and MDA are closely related to the impairment of EDF in IGT and type 2 DM.