糖耐量减低的绝经后女性和肽素水平与冠状动脉粥样硬化病变的相关性  

The association of copeptin levels with coronary atherosclerotic lesions in postmenopausal women with impaired glucose tolerance

作　　者：张凯 苑小历[2] 胡文星[3] 肖平喜 卢新政 

机构地区：[1]南京医科大学附属逸夫医院心内科,江苏南京211166 [2]南京军区南京总医院干部保健科,江苏南京210002 [3]南京军区南京总医院皮肤科,江苏南京210002

出　　处：《南京医科大学学报（自然科学版）》2018年第1期72-75,共4页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的:观察糖耐量减低的绝经后女性血浆和肽素(copeptin)水平与冠状动脉粥样硬化病变的相关性。方法:将80例新发糖耐量减低(空腹血糖<7.0 mmol/L,7.8 mmol/L≤早餐后2 h血糖<11.0 mmol/L)的绝经后女性(年龄56~59岁)依据基线copeptin水平分成A组(<5 pmol/L)、B组(>20 pmol/L),每组各收集40例。分析两组间基线时和6个月后冠状动脉(CTA)狭窄程度积分的差异。结果:(1)基线时,A组与B组之间的copeptin水平差异有统计学意义(P<0.05),而在体重、空腹全血血糖、早餐后2 h血糖、空腹血清甘油三酯、血清总胆固醇、血清低密度脂蛋白胆固醇、平均动脉压、血清肌酐水平、年龄等指标上差异无统计学意义。(2)经治疗性生活方式调整及口服阿司匹林(100 mg/d)、瑞舒伐他汀(10 mg/d)6个月后,在copeptin水平、冠脉CTA的狭窄程度积分、空腹全血血糖、早餐后2 h血糖指标上,B组明显高于A组,差异有统计学意义(P<0.05),且B组有糖尿病、冠心病的发病,A组没有。结论:在糖耐量减低、绝经后女性的冠心病危险因素的基础上,高血浆copeptin水平会进一步促进冠状动脉粥样硬化病变发生和恶化。Objective：To observe the association of copeptin levels with coronary atherosclerotic lesions in postmenopausal women with impaired glucose tolerance（IGT）. Methods：Eighty postmenopausal women（aged 56-59 y）with the onset of IGT（fasting blood glucose,i.e. FBG7.0 mmol/L,7.8 mmol/L≤2-hour postprandial blood glucose,i.e.2 h PBG11.0 mmol/L）were divided into group A（copeptin 5 pmol/L）and group B（copeptin 20 pmol/L）,according to serum copeptin levels at baseline,40 cases in each group. The discrepancy of coronary CTA stenosis scores was analyzed between the two groups at baseline and after 6-month follow-up. Results：（1）At baseline,the difference was statistically significant in copeptin levels（P〈0.05）,but not in weight,FBG,2 h PBG,fasting serum triglyceride（TG）,total serum cholesterol（TC）,serum low-density lipoprotein cholesterol（LDL-C）,mean arterial pressure,serum creatinine and age between group A and group B（P〈0.05）.（2） After 6-month therapeutic lifestyle adjustment as well as oral administration of aspirin（100 mg qd）and rosuvastain（10 mg qd）,copeptin level,coronary CTA stenosis scores,FBG and 2 h PBG of group B was statistically significantly higher,compared with group A,respectively（P〈0.05）.Furthermore,some cases developed diabetes or coronary heart disease（CHD）in group B,while not in group A. Conclusion：On the basis of the influence of the atherosclerotic risk factors of IGT and postmenopausal female,high plasma copeptin level will further promote the occurrence and deterioration of coronary atherosclerotic lesions.

关 键 词：和肽素 精氨酸血管加压素 糖耐量减低 绝经期 女性 冠状动脉粥样硬化 

分 类 号：R541.4[医药卫生—心血管疾病]