高脂餐后内皮依赖性血管舒张功能变化及其影响因素  

Impaired endothelial function after a high-fat meal and the associated influencing factor

作　　者：赵水平[1] 刘玲[1] 高梅[2] 周启昌[2] 李玉玲[3] 夏冰[3] 

机构地区：[1]湖南医科大学附属第二医院心内科,长沙410011 [2]湖南医科大学附属第二医院B超室,长沙410011 [3]湖南医科大学附属第二医院营养科,长沙410011

出　　处：《中华心血管病杂志》2000年第4期267-270,共4页Chinese Journal of Cardiology

摘　　要：目的　探讨高脂餐后血清甘油三酯 (TG)代谢与内皮依赖性血管舒张功能变化的关系。方法　 75例血清总胆固醇 (TC)正常的受试者在禁食 12h后 ,接受高脂餐负荷试验。分别采集餐前及餐后 2、4、5、7h静脉血标本 ,用以测定血清TG浓度以及血清TC、低密度脂蛋白 胆固醇 (LDL C)、高密度脂蛋白 胆固醇 (HDL C)浓度。采用高分辨血管外超声法检测餐前及餐后 4h肱动脉血流介导的内皮依赖性血管舒张功能。结果　餐后 2～ 7h血清TG浓度显著升高。餐后血清TC、HDL C、LDL C浓度无显著变化。所有受试者餐后 4h内皮依赖性血管舒张功能均严重受损 [(4 2 2± 0 44 ) %与(2 75± 0 33) % ,P值 <0 0 1]。经相关分析结果显示 :餐后 2h血清TG浓度增高值与餐后 4h内皮依赖性血管舒张功能下降值显著正相关 (r=0 45 9,P =0 0 0 6 )。根据餐后 2h血清TG浓度增高值将受试者分为两组 :餐后TG增高显著组 (餐后 2h血清TG浓度增高值 >0 5 8mmol/L ,A组 ,n =37)与不显著组 (增高值≤ 0 5 8mmol/L ,B组 ,n =38)。A组受试者餐后 4h内皮依赖性血管舒张功能受损[(4 19± 0 71) %与 (1 30± 0 45 ) % ,P <0 0 5 ],B组受试者餐后 4h内皮依赖性血管舒张功能无改变[(4 2 7± 0 47) %与 (4 17± 0 45 ) % ]。结论　高脂餐后内皮?Objective To explore whether postprandial hypertriglyceridemia impairs endothelium-dependent vasodilatation after a single high-fat meal (800 calorie; 50g fat). Methods Seventy-five subjects with normal serum total cholesterol concentration were studied. The concentrations of triglyceride, total cholesterol, LDL cholesterol (LDL-C), and HDL cholesterol (HDL-C) in fasting serum and at 2,4,5,7 hours after a single high-fat meal were measured. Endothelial function, in form of flow-mediated vasodilatation, was assessed in the brachial artery by high-resolution ultrasound technique before and 4 hours after meal. Results The postprandial serum triglyceride concentrations increased significantly at 2-7 hours after the high-fat meal in all subjects. No obvious change was observed in the postprandial total cholesterol, LDL-C and HDL-C levels. The postprandial endothelium-dependent vasodilatation in all subjects was impaired significantly [(4 22±0 44)% vs (2 75±0 33)%, P <0 01]. The change of postprandial endothelium-dependent vasodilatation was positively correlated with the change of 2-hour serum triglyceride ( r =0 459, P =0 006). According to the increment of serum triglyceride 2 hours after meal, all subjects were divided into two groups: group A (the increment >0 58 mmol/L, n =37) and group B (the increment ≤0 58 mmol/L, n =38). The postprandial endothelium dependent vasodilatation in group A was impaired obviously [(4 19±0 71)% vs (1 30±0 45)%, P <0 05], while in group B no significant change occurred [(4 27±0 47)% vs (4 17±0 45)%]. Conclusions The postprandial endothelium-dependent vasodilatation after a single high-fat meal was impaired in subjects who had normal serum TC concentrations. The disordered postprandial metabolism of triglyceride riched lipoproteins (TRLs) might play an atherogenic role by inducing the endothelial dysfunction.

关 键 词：高脂餐 血清 甘油三酯 内皮依赖性血管舒张功能 

分 类 号：R589.2[医药卫生—内分泌]