CAJ | 학술논문

目的探讨糖脂联合负荷对高血压患者糖脂代谢及血管内皮功能的影响.方法 98例高血压患者随机分为三组,单纯脂肪餐负荷组(n=38),糖负荷组(n=26),糖脂联合负荷组(n=34),分别进行脂肪餐负荷试验,口服葡萄糖耐量试验及糖脂联合负荷试验.葡萄糖曲线下面积(GS-AUC)作为糖负荷后血糖反应水平的指标,以甘油三酯(TG)曲线下面积(TG-AUC),TG峰浓度(TGPR)作为脂肪餐负荷后TG反应水平的指标;用血管超声测定肱动脉内皮依赖性扩张功能(FMD)作为血管内皮功能指标.结果 (1)高血压患者脂肪餐负荷后出现明显TG代谢异常,明显高于正常血压对照组(P＜0.05),且FMD明显下降,4 h下降达高峰(下降29.2%),8 h后恢复正常.(2)高血压患者急性糖负荷后GS-AUC及1 h血糖明显高于正常血压对照组(P＜0.05),FMD在负荷后1 h即显著下降(下降31.4%),2 h恢复正常.(3)糖脂联合负荷后血TG反应水平、GS-AUC及1 h血糖虽然分别与单纯脂肪餐负荷组、糖负荷组差异无统计学意义,但负荷后1 h的FMD明显低于单纯糖负荷组(5.45±1.93比9.46±3.33,P＜0.05),4 h时的FMD也低于单纯脂肪餐负荷组(7.98±1.64比9.66±2.26,P＜0.05).(4)相关分析显示,FMD与收缩压,GS-AUC,舒张压,TG-AUC呈负相关,γ分别为-0.46,-0.44,-0.41,-0.38(P＜0.05).结论糖脂联合负荷对高血压患者血管内皮损伤有协同作用.
목적 탐토당지연합부하대고혈압환자당지대사급혈관내피공능적영향.방법 98례고혈압환자수궤분위삼조,단순지방찬부하조(n=38),당부하조(n=26),당지연합부하조(n=34),분별진행지방찬부하시험,구복포도당내량시험급당지연합부하시험.포도당곡선하면적(GS-AUC)작위당부하후혈당반응수평적지표,이감유삼지(TG)곡선하면적(TG-AUC),TG봉농도(TGPR)작위지방찬부하후TG반응수평적지표;용혈관초성측정굉동맥내피의뢰성확장공능(FMD)작위혈관내피공능지표.결과 (1)고혈압환자지방찬부하후출현명현TG대사이상,명현고우정상혈압대조조(P＜0.05),차FMD명현하강,4 h하강체고봉(하강29.2%),8 h후회복정상.(2)고혈압환자급성당부하후GS-AUC급1 h혈당명현고우정상혈압대조조(P＜0.05),FMD재부하후1 h즉현저하강(하강31.4%),2 h회복정상.(3)당지연합부하후혈TG반응수평、GS-AUC급1 h혈당수연분별여단순지방찬부하조、당부하조차이무통계학의의,단부하후1 h적FMD명현저우단순당부하조(5.45±1.93비9.46±3.33,P＜0.05),4 h시적FMD야저우단순지방찬부하조(7.98±1.64비9.66±2.26,P＜0.05).(4)상관분석현시,FMD여수축압,GS-AUC,서장압,TG-AUC정부상관,γ분별위-0.46,-0.44,-0.41,-0.38(P＜0.05).결론 당지연합부하대고혈압환자혈관내피손상유협동작용.
Objective To explore the influence of acute glucose and fat loading on endothelium dependent flow-mediated vasodilation (FMD) in patients with essential hypertension (EH). Methods Patients with EH were randomly divided into three groups: oral glucose loading alone (n = 26 ), oral standardized fat loading alone (n = 38), combined glucose and fat loading (n = 34 ). FMD of the brachial artery was assessed by high resolution ultrasound technique respectively. Results ( 1 ) Compared to control group, postrandial abnomal serum triglyceride metabolism was evidenced and FMD was significantly reduced and the lowest FMD occurred at 4 hours and returned to the baseline level at 8 hours post fat loading alone in EH patients. (2) GS-AUC and 1 hour glucose were significantly higher in EH patients than in controls (all P ＜0. 05), FMD was also significant decreased ( -31.4% ) at 1 hour and returned to baseline level at 2 hours post oral glucose loading. ( 3 ) After combined glucose and fat loading, FMD at 1 hour ( 5.45 ± 1.93 vs. 9.46 ± 3.33, P ＜ 0.05 ) was significantly lower than that in glucose loading alone and FMD at 4 hours ( 7. 98 ± 1. 64 vs. 9. 66 ± 2. 26, P ＜ 0. 05 ), was also lower than that in fat loading alone in EH patients.(4) FMD was negatively correlated with SBP, GS-AUC, DBP, TG-AUC ( γ= - 0. 46, - 0. 44, - 0. 41,- 0. 38,respectively, all P ＜ 0. 05 ). Conclusion Combined glucose and fat loading additively reduced FMD in hypertensive patients.