单纯空腹血糖受损者内皮功能改变及其危险因素分析  

Changes of Endothelial Function and the Risk Factors in Persons with Isolated Impaired Fasting Glucose

作　　者：吕以培[1] 车红英[1] 黄文萍[1] 陈建西[1] 张素华[1] 黄中莹[1] 杨丕坚[1] 李舒敏[1] 卢伟波[1] 罗文意[1] 

机构地区：[1]广西壮族自治区钦州市第二人民医院,535000

出　　处：《中国全科医学》2013年第34期4044-4048,4061,共6页Chinese General Practice

基　　金：广西科学研究与技术开发计划项目基金(桂科攻0816004-26)

摘　　要：目的探讨单纯空腹血糖受损(I-IFG)者的内皮功能改变及其危险因素。方法根据2005年国际糖尿病联盟肥胖标准(男性腰围≥90 cm、女性腰围≥80 cm为肥胖)分为肥胖和非肥胖组,选择I-IFG者60例(非肥胖即C1亚组28例,肥胖即C2亚组32例)与糖耐量正常者142例(非肥胖即N1亚组75例,肥胖即N2亚组67例)做比较,做口服葡萄糖耐量试验及胰岛素释放试验,检测0 min、10 min、20 min、30 min、60 min、120 min血糖、免疫活性胰岛素,同时检测空腹血脂、游离脂肪酸、脂联素、超敏C反应蛋白(hs-CRP)、血内皮素(SET),留取晨尿测定尿内皮素(UET)与微量清蛋白(MUA),记录糖尿病家族史并观察血压、身高和体质量,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 I-IFG与糖耐量正常者比较,校正性别、年龄后,MUA、hs-CRP、内皮依赖性血管舒张功能(EDD)和内皮非依赖性血管舒张功能(EID)差异有统计学意义(P<0.05),SET和UET差异有统计学意义(P<0.01);C2亚组与N2亚组比较EDD、EID和MUA差异有统计学意义(P<0.05),SET及UET差异有统计学意义(P<0.01),而C1亚组与N1亚组比较SET和UET差异有统计学意义(P<0.01);多元回归分析显示,以内皮指标为应变量能进入方程的有糖尿病家族史、肥胖、血压、脂代谢、血糖及胰岛分泌功能等指标。结论 I-IFG肥胖者以大血管内皮改变为主,同时有微血管内皮改变;非肥胖者以微血管内皮改变为主。糖尿病家族史和代谢性因素诸如肥胖、血压增高、脂代谢紊乱、血糖增高和胰岛功能的改变等是I-IFG者内皮功能改变的独立危险因素。Objective To explore the changes of endothelial function and the characteristics of risk factors in persons with isolated impaired fasting glucose （ I - IFG） . Methods Based on the diagnosing criteria of obesity set by International Dia- betes Federation （IDF） in 2005 （ waistline〉t90 cm for males and waisdine≥80 cm for females）, 60 1 - IFG persons were divid- ed as non-obesity subgroup （C1 group, n =28） and obesity subgroup （C2 group, n = 32） ; while 142 person with normal glucose tolerance were divided as non - obesity subgroup （ N1 group, n = 75 ） and obesity subgroup （ N2 group, n = 67 ） . Of all the subjects oral glucose tolerance test and insulin release test were measured, detecting blood sugar contents at 0 rain, 10 min, 20 min, 30 min, 60 min and 120 min, as well as the contents of immunoreactive insulin; at the same time, the parame- ters of their fasting blood lipids, free fatty acids, adiponectin, high - sensitivity C - reactive protein （ hs - CRP）, serum endo- thelin - 1 （ SET）, urine endothelin - 1 （UET） and urea - microalbumin （MUA） were also measured. Their family histories of diabetes were recorded, and their blood pressure, height and weight were observed, find the changes of arteria brachialis diame- ter were tested at rest, under the pressure and after medication of glyceryl trinitrate. Results After adjusting for sex and age, there were significant differences between the C （C1 and C2） groups and the N （N1 and N2） groups in MUA, hs- CRP, endothehum - dependent vasodilatation （EDD） and endothelium - independent vasodilatation （EID） （ P 〈 0. 05 ） ; and in SET and UET （P 〈0. 01 ） . There were significant differences between the C2 and the N2 groups in EDD, EID and MUA （P 〈 0. 05） ; and in SET and UET （ P 〈0. 01 ） . And there were significant differences between the C1 and the N1 group only in SET and UET （P 〈0. 01 ） . The multivariate regression analysis showed that family history of diabetes mellitus, o

关 键 词：空腹血糖受损 肥胖 内皮功能 危险因素 代谢 

分 类 号：R349.14[医药卫生—基础医学]