医学信息
醫學信息
의학신식
Medical Information
2015年
43期
143-144
,共2页
吕以培%黄文萍%车红英%张素华%黄中莹%杨丕坚%黄虹%李舒敏%卢伟波%罗文意
呂以培%黃文萍%車紅英%張素華%黃中瑩%楊丕堅%黃虹%李舒敏%盧偉波%囉文意
려이배%황문평%차홍영%장소화%황중형%양비견%황홍%리서민%로위파%라문의
中间高血糖%内皮功能%家族史%代谢
中間高血糖%內皮功能%傢族史%代謝
중간고혈당%내피공능%가족사%대사
Intermediate hyperglycemia%Endothelial function%Family history%Metabolism
目的探讨中间高血糖(IHG)及其各组份单纯空腹血糖受损(I-IFG,C组)、单纯糖耐量受损(I-IGT,D组)及空腹血糖受损合并糖耐量受损(IFG﹢IGT,E组)的内皮功能损害与遗传和代谢性因子的关系。方法 IHG者共215例,包括C组60例、D组83例和E组72例,与糖耐量正常者(N组)共142例作对照,作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(FFA)、脂联素(APN)、超敏C反应蛋白(hs-CRP)、内皮素(SET),留取晨尿测定内皮素(UET)与微量白蛋白(MUA),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。结果校正年龄和性别后,IHG组、C组、D组、E组的内皮指标hs-CRP、MUA、SET、UET、EDD及EID与N组比较有显著性差异(<0.05或<0.01),D组的hs-CRP、SET和UET与C组比较有显著性差异(<0.05或<0.01),E组的hs-CRP、MUA、SET、UET和EDD分别与C组和D组比较有显著性差异(<0.05或<0.01)；因子分析显示六个因子中其中五个甘油三酯、胰岛素水平、胰岛素抵抗、血糖和血压因子与内皮改变关系密切,其中家族史和肥胖等变量与多个因子密切相关。结论 IHG及其各组分均出现了大血管和微血管内皮功能损害,C组较轻,D组较重,E组最严重；在家族史和肥胖的基础上独立或联合如血脂、葡萄糖、胰岛功能、胰岛素抵抗和血压等代谢因素损害IHG内皮功能。
目的探討中間高血糖(IHG)及其各組份單純空腹血糖受損(I-IFG,C組)、單純糖耐量受損(I-IGT,D組)及空腹血糖受損閤併糖耐量受損(IFG﹢IGT,E組)的內皮功能損害與遺傳和代謝性因子的關繫。方法 IHG者共215例,包括C組60例、D組83例和E組72例,與糖耐量正常者(N組)共142例作對照,作口服葡萄糖耐量試驗及胰島素釋放試驗,檢測0min 、10min、20min、30min、60min、120min血糖、免疫活性胰島素,同時檢測空腹血脂、遊離脂肪痠(FFA)、脂聯素(APN)、超敏C反應蛋白(hs-CRP)、內皮素(SET),留取晨尿測定內皮素(UET)與微量白蛋白(MUA),併觀察血壓、身高和體重,測定肱動脈休息時、加壓及服用硝痠甘油後的內徑變化。結果校正年齡和性彆後,IHG組、C組、D組、E組的內皮指標hs-CRP、MUA、SET、UET、EDD及EID與N組比較有顯著性差異(<0.05或<0.01),D組的hs-CRP、SET和UET與C組比較有顯著性差異(<0.05或<0.01),E組的hs-CRP、MUA、SET、UET和EDD分彆與C組和D組比較有顯著性差異(<0.05或<0.01)；因子分析顯示六箇因子中其中五箇甘油三酯、胰島素水平、胰島素牴抗、血糖和血壓因子與內皮改變關繫密切,其中傢族史和肥胖等變量與多箇因子密切相關。結論 IHG及其各組分均齣現瞭大血管和微血管內皮功能損害,C組較輕,D組較重,E組最嚴重；在傢族史和肥胖的基礎上獨立或聯閤如血脂、葡萄糖、胰島功能、胰島素牴抗和血壓等代謝因素損害IHG內皮功能。
목적탐토중간고혈당(IHG)급기각조빈단순공복혈당수손(I-IFG,C조)、단순당내량수손(I-IGT,D조)급공복혈당수손합병당내량수손(IFG﹢IGT,E조)적내피공능손해여유전화대사성인자적관계。방법 IHG자공215례,포괄C조60례、D조83례화E조72례,여당내량정상자(N조)공142례작대조,작구복포도당내량시험급이도소석방시험,검측0min 、10min、20min、30min、60min、120min혈당、면역활성이도소,동시검측공복혈지、유리지방산(FFA)、지련소(APN)、초민C반응단백(hs-CRP)、내피소(SET),류취신뇨측정내피소(UET)여미량백단백(MUA),병관찰혈압、신고화체중,측정굉동맥휴식시、가압급복용초산감유후적내경변화。결과교정년령화성별후,IHG조、C조、D조、E조적내피지표hs-CRP、MUA、SET、UET、EDD급EID여N조비교유현저성차이(<0.05혹<0.01),D조적hs-CRP、SET화UET여C조비교유현저성차이(<0.05혹<0.01),E조적hs-CRP、MUA、SET、UET화EDD분별여C조화D조비교유현저성차이(<0.05혹<0.01)；인자분석현시륙개인자중기중오개감유삼지、이도소수평、이도소저항、혈당화혈압인자여내피개변관계밀절,기중가족사화비반등변량여다개인자밀절상관。결론 IHG급기각조분균출현료대혈관화미혈관내피공능손해,C조교경,D조교중,E조최엄중；재가족사화비반적기출상독립혹연합여혈지、포도당、이도공능、이도소저항화혈압등대사인소손해IHG내피공능。
Objective To explore characteristics of risk factors and endothelial dysfunction in intermediate hyperglycemia (group IHG) besides isolated impaired fasting glucose (I-IFG ,group C) , isolated impaired glucose tolerance (I-IGT,group D) and impaired fasting glucose combining impaired glucose tolerance (IFG﹢IGT,group E) .Methods 215 cases of IHG were divided into 60 cases of group C and 83 cases of group D and 72 cases of group E, and compare to142 cases of normal glucose tolerance (group N). Al cases were detected glucose and insulin of 0min,10min,20min,30min, 60min and 120min with oral glucose tolerance test and insulin release test ,and fasting of blood lipids,free fat y acids (FFA),adiponectin (APN)and serum endothelin-1 (SET-1), and urine endothelin-1 (UET-1)and urea-microalbumin (MUA)after col ecting urina sanguinis . To be observed blood pressure,height and weight ,and the arteria brachialis diameter was tested at lest and after arteria brachialis elevated pressure and glycergl trintrate .Results It is significant dif erence between group IHG and group N in hs-CRP,MUA,SET,UET,endothelium-dependent hs-CRP,MUA, SET,UET,endothelium-dependent vasodilatation (EDD), and endothelium-Independent vasodilatation (EID) ,and between group D and group C in hs-CRP,SET and UET ,and between group E and group C/group D in hs-CRP,MUA,SET,UET and EDD after adjusting for sex and age ( <0.05 or <0.01).In factor analysis, triglyceride, level of insulin,insulin resistance, blood glucose and blood pressure in five of six factors are closely related with endothelial dysfunction,and family history and obesity so on are closely related with some factors .Conclusion The endothelial dysfunction in microvessel and greatvessel are founded in group and among of IHG including group E, group D and group C ,the most serious one is group E,more serious one is group D .This finding indicates that metabolic risk factors are independent risk factors or someone are abonder for endothelial dysfunction in IHG such as blood glucose,blood lipid, insulin resistance , insulin secretion function and blood pressure on the basis of obesity and family history of diabetes mel itus.
