空腹血糖受损并糖耐量受损患者血管内皮功能及代谢功能观察  

Observation on vascular endothelial function and metabolic function in impaired fasting glucose combining impaired glucose tolerance

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

机构地区：[1]钦州市第二人民医院,广西钦州535000

出　　处：《山东医药》2014年第39期19-22,26,共5页Shandong Medical Journal

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：目的观察空腹血糖受损并糖耐量受损(IFG+IGT)患者血管内皮功能及代谢功能情况。方法选择IFG+IGT者72例(E组),其中非肥胖30例(E1组),肥胖42例(E2组);另选择糖耐量正常的健康人群142例(N组),其中非肥胖75例(N1组)、肥胖67例(N2组)。做口服葡萄糖耐量试验及胰岛素释放试验检测血糖、免疫活性胰岛素,同时检测空腹血脂、游离脂肪酸、脂联素。采用免疫比浊法检测超敏C反应蛋白(hs-CRP),RIA法检测血清内皮素(SET)。留取晨尿,采用未抽提法测定内皮素(UET),散射比浊法检测尿微量白蛋白(MUA)。观察血压和腰围。彩超测定肱动脉休息时、加压及服用硝酸甘油后的内径变化,计算内皮依赖性血管舒张功能(EDD)及内皮非依赖性血管舒张功能(EID)指标(ΔD%、ΔD1%)。结果校正性别、年龄后,E和N组比较、E2与N2组比较及E1与N1组比较,MUA、hs-CRP、UET、SET、ΔD%、ΔD1%差异有统计学意义(P均<0.05);N2与N1组比较hsCRP、UET和SET差异有统计学意义(P均<0.05);E2与E1组比较MUA、hs-CRP、UET和SET差异有统计学意义(P均<0.05)。结论 IFG+IGT患者大血管和微血管内皮功能均出现异常,尤以肥胖者为著;患者的代谢功能亦出现异常,主要表现为高血压、高血糖、脂代谢紊乱、胰岛素抵抗及胰岛分泌功能下降。Objective To investigate the vascular endothelial function and metabolic function in patients with im-paired fasting glucose combining impaired glucose tolerance（ IFG＋IGT） .Methods 72 cases of IFG＋IGT（ group E） in-cluding 42 cases of obesity（group E2）and 30 cases of no-obesity（group E1） were compared to 142 cases of normal glucose tolerance（group N） including 67cases of obesity（groupN2） and 75 cases of no-obesity（group N1）.Glucose and insulin were detected in all cases by oral glucose tolerance test and insulin release test.Fasting venous blood of all samples were obtained to measure fasting lipid-related indicators by automatic biochemical analyzer.Serum endothelin-1（SET） was de-tected by RIA and high-sensitivity C-reactive protein（ hs-CRP） was detected by immunoturbidimetry.The urine endothelin-1（ UET） was tested by no extract direct method of RIA, and urea-microalbumin（ MUA） was tested by nephelometry after collecting urina sanguinis.The brachial artery diameter at basal（ Db） , reactive hyperemic（ Dh） and sublingual nitroglycer-in（ Dn） conditions were measured by color Doppler ultrasound respectively.The blood pressure and waist, calculated endo-thelium-dependent vasodilatation （ EDD, ΔD%） and endothelium-independent vasodilatation （ EID, ΔD1%） were also measured respectively.Results The differences of MUA, Hs-CRP, SET, UET,ΔD%andΔD1%after adjusting for sex and age were all significant between group E and group N, group E2 and group N2, group E1 and group N1 （ all P〈0.05）.It was significant difference between group N2 and group N1 in Hs-CRP, SET and UET（all P〈0.05）.It was also significant difference between group E2 and group E1 in MUA, Hs-CRP, SET and UET（all P〈0.05）.Conclusions The impaired endothelial function which occures in macrovascular and microvascular is found in the patients with IFG and IGT＆amp;nbsp;and it is serious in the cases of obese patients.The patients with IFG and IGT occure metabolic dysfunction ma

关 键 词：空腹血糖受损 糖耐量受损 肥胖 内皮功能 代谢功能 

分 类 号：R587.1[医药卫生—内分泌]