急性高血糖对2型糖尿病患者一级亲属血管内皮功能的抑制作用  

Acute hyperglycemia rapidly suppresses endothelium-dependent arterial dilation in first-degree relatives of type 2 diabetic patients

作　　者：向光大[1] 浦金辉[1] 赵林双[1] 侯洁[1] 乐岭[1] 

机构地区：[1]广州军区武汉总医院内分泌科,湖北430070

出　　处：《中国糖尿病杂志》2010年第5期359-361,共3页Chinese Journal of Diabetes

基　　金：全军"十一五"计划面上项目(06MB166)

摘　　要：目的探讨急性高血糖对2型糖尿病(T2DM)患者一级亲属血流中介内皮依赖性血管舒张功能(FMD)的影响。方法选择32例正常葡萄糖耐量个体,其中,父母均为糖尿病患者的17例[家族史阳性组(FH+组)];一级亲属无DM及冠心病者15例[家庭史阴性组(FH-组)]。采用高分辨血管外超声测定空腹状态、口服75g葡萄糖后1～2h FMD。结果与FH一组相比,FH+组空腹状态及服糖后1～2h FMD明显降低。在FH+组,与0h相比,1h FMD明显降低;与1h相比,2h FMD明显增高,但仍明显低于空腹状态。回归分析显示,FMD与FH+相关。FH+组FMD与血糖、硫巴比妥酸反应物相关(P<0.05或P<0.01)。结论 FH+个体存在血管内皮功能异常;急性高血糖快速降低其FMD。因此,推测T2DM家族史可作为额外的心血管病危险因子。Objective To examine whether endothelial dysfunction occurs when acute hyperglycemia is induced by oral glucose loading in this cohort. Methods This study included 32 subjects with normal glucose tolerance. Of them, 17 cases had type 2 diabetic parents （FH＋） and 15 cases had first-degree relatives without diabetes and coronary artery disease （FH＋）. The examination of vascular function was performed by high resolution ultrasound. Results As compared with FH- group, the endothelium- dependent arterial dilation（FMD） in FH ＋ group was significantly lower before and after oral glucose loading （P〈0.05）. In FH＋ group, FMD decreased significantly at 60 min versus at baseline and increased markedly at 120rain as compared with at 60min, which was still significantly lower than at baseline （P〈0.05）. In multiple regression analysis, FMD was significantly correlated to FH＋ （P〈 0.01）. FMD showed a correlation with plasma glucose and TBARs（P〈0.01） during the OGTT in FH＋ subjects. Conclusions Significant endothelial dysfunction occurs in FH＋ subjects. Also, FMD is rapidly impaired in response to glucose loading in FH ＋ subjects. The results suggest that strong family history of type 2 diabetes could be considered an additional cardiac risk factor.

关 键 词：糖尿病 2型 一级亲属 血管内皮功能异常 急性高血糖 

分 类 号：R587.1[医药卫生—内分泌]