空腹血糖受损人群颈动脉内膜中层厚度和血管内皮细胞功能的变化  

Study of carotid intima-media thickness and vascular endothelial cell function in people with impaired fasting glucose

作　　者：金国玺[1] 毕娅欣[1] 于磊[1] 胡小磊[1] 周静[1] 张士荣[1] 王路[1] 

机构地区：[1]蚌埠医学院第一附属医院内分泌科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2011年第6期557-560,共4页Journal of Bengbu Medical College

基　　金：安徽省卫生厅医学科研课题计划资助项目(09A014);安徽省教育厅自然科学研究资助项目(2003KJ264)

摘　　要：目的:探讨空腹血糖受损者颈动脉内膜中层厚度(IMT)及血管内皮功能的变化及其危险因素。方法:测量30名成年人正常葡萄糖耐量(NGT组)、45例单纯空腹血糖受损(IFG组)者血糖、胰岛素、血脂等临床指标,并以彩色多普勒超声测量受试者的IMT,检测2组的血浆内皮素-1(ET-1)和一氧化氮(NO)的水平。结果:IFG组的IMT、ET-1和NO均高于NGT组(P<0.01);IMT与体重指数(BMI)、收缩压(SBP)、NO、甘油三酯(TG)、ET-1、空腹胰岛素(FINS)、HOMA胰岛素抵抗指数(HOMA-IR)及舒张压(DBP)呈正相关关系(P<0.05～P<0.01);NO与IMT、SBP、ET-1、TG、FINS、HOMA-IR、HOMA胰岛细胞功能(HOMA-β)、DBP呈正相关关系(P<0.05～P<0.01);ET-1与IMT、SBP、NO、BMI、FINS、HOMA-IR、HOMA-β及TG呈正相关关系(P<0.05～P<0.01)。IMT影响因素依次为NO、TG、空腹血糖、ET-1;ET-1的影响因素依次为NO、餐后2 h血糖;NO的影响因素依次为SBP、ET-1。结论:IFG人群的颈动脉内膜中层厚度,其血管内皮细胞功能已发生变化;早期干预可以改善IFG人群的胰岛功能、减少糖尿病的发生,也可以减少动脉粥样硬化的发生、发展。Objective：To explore the changes of carotid intima-media thickness （IMT） and vascular endothelium function in people with impaired fasting glucose（IFG） as well as the risk factors. Methods：The anthropometric variables,fasting blood glucose（FBG） ,2- hour postprandial blood glucose （ PBG ）, fasting blood insulin （ FINS ）, postprandial blood insulin （ PINS ）, systolic pressure （ SBP ）, diastolic pressure （DBP）, blood lipid and other clinical parameters were measured in 30 controls with normal glucose tolerance （NGT） and 45 people with impaired fasting glucose（IFG）. The carotid IMT was measured by color Doppler ultrasound, the blood endothelin 1 （ET-1）was tested by enzyme-linked immune sorbent assay （ELISA） and the blood nitric oxide（NO） by nitrate reductase assay in all the subjects. Results ：There were significant differences in the levels of IMT, ET-1 and NO between IFG group and NGT group （P 〈 0.01 ）. According to linear correlation analysis, IMT showed positive correlation with body mass index （BMI）, SBP, blood NO, triglyceride （ TG）, ET-1, FINS, HOMA insulin resistance index （HOMA-IR） and DBP respectively （ P 〈 0.05 - P 〈 0.01 ） ; the level of blood NO showed positive correlation with IMT, SBP, ET-1, TG, FINS, HOMA-IR, HOMA-β cell function index （HOMA-β） and DBP, respectively（P 〈 0.05 - P 〈 0.01 ）. The level of blood ET-1 showed positive correlation with IMT, SBP, NO, BMI, FINS, HOMA-IR, HOMA-β and TG, respectively（P 〈 0.05 -P 〈 0.01 ）. According to multiple regression analysis, the risk factors of IMT were NO, TG, FBG and ET-1 in sequence,the risk factors of blood ET-1 were blood NO and PBG ,and the risk factors of blood NO were SBP and ET-1 in sequence. Conclusions ：The IMT,blood ET-1 and NO increase greatly in adults with impaired fasting glucose, and their vascular endothelial function has changed significantly compared with that of people with NGT. Early intervention may improve the islet function o

关 键 词：血糖 空腹血糖受损 颈动脉内膜中层厚度 内皮素-1 一氧化氮 

分 类 号：R446.112[医药卫生—诊断学]