老年人餐后血糖对血流剪切力及血流介导的血管舒张功能的影响  

Effect of postprandial plasma glucose on blood flow shear stress and flow-mediated vasodilatation in the elderly

作　　者：王梅[1] 王秀红[2] 刘振东[3] 赵颖馨[3] 张华[3] 栾萌[3] 

机构地区：[1]济南市民族医院心血管内科,250000 [2]山东省地方病防治研究所 [3]山东省医学科学院基础医学研究所

出　　处：《中华老年心脑血管病杂志》2015年第8期816-819,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81470489);山东省自然科学基金(ZR2014HM098;ZR2012HL46;ZR2014HQ042);山东省医药卫生科技发展计划(2014WS0312;2014WS0316;2013WS0364;2013WS0176)

摘　　要：目的探讨老年人餐后2h血糖(2hPG)对颈动脉血流剪切力及血流介导的血管舒张功能(FMD)的影响。方法选择老年健康体检者230例,根据口服葡萄糖耐量试验结果和国际糖尿病联盟发布的血糖管理指南,将受试者分为血糖正常组91例、血糖升高组75例及新诊断糖尿病组(糖尿病组)64例。检测所有受试者颈动脉血流剪切力及肱动脉FMD。结果与血糖正常组比较,血糖升高组和糖尿病组平均剪切力、峰值剪切力和FMD明显降低(P<0.05)。与血糖升高组比较,糖尿病组平均剪切力[(0.76±0.14)Pa vs(0.84±0.16)Pa]、峰值剪切力[(1.65±0.42)Pa vs(1.83±0.41)Pa]和FMD[(9.32±2.71)%vs(10.85±3.10)%]明显降低(P<0.05)。Pearson相关分析显示,2hPG及空腹血糖与平均剪切力、峰值剪切力及FMD呈负相关(P<0.01)。FMD与平均剪切力及峰值剪切力呈正相关(P<0.01)。在校正年龄、性别等相关混杂因素后,2hPG始终是影响平均剪切力、峰值剪切力及FMD的主要因素。结论老年人2hPG与剪切力及FMD相关,2hPG升高可使剪切力下降,并导致FMD紊乱。Objective To study the effect of 2 h postprandial plasma glucose （2 h PG） on blood flow shear stress （SS） and flow-mediated vasodilatation （FMD） in the elderly. Methods Two hundred and thirty elderly subjects undergoing physical examination were divided in control group （n=91） ,postprandial hyperglycemia group （n=75） and diabetes mellitus （DM） group （n=64） ac- cording to their OGTT and blood glucose management guide issued by International Diabetes Fed- eration. Their carotid artery blood flow SS and brachial artery FMD were detected. Results The mean carotid artery blood flow SS, peak carotid artery blood flow SS and brachial artery FMD were significantly lower in postprandial hyperglycemia group and DM group than in control group （P^0.05） and in DM group than in postprandial hyperglycemia group （P〈0.05）. Pearson corre- lation analysis showed that the 2 h PG and FPG were negatively related with the mean carotid ar- tery blood flow SS,peak carotid artery blood flow SS and brachial artery FMD whereas the bra- chial artery FMD was positively related with the mean carotid artery blood flow SS and peak ca- rotid artery blood flow SS （P〈0.01）. Conclusion The 2 h PG is related with the carotid artery blood flow SS and brachial artery FMD in the elderly. Increased 2 h PG induces the decline of ca- rotid artery blood flow SS and disorder of brachial artery FMD.

关 键 词：血糖 饭后期间 葡糖耐量试验 血管舒张 高血糖症 糖尿病 血流动力学 颈动脉 

分 类 号：R587.1[医药卫生—内分泌]