糖耐量低减患者血管内皮舒张功能的超声评价

Evaluation on brachial endothelial function in patients with impaired glucose tolerance via ultrasonography

目的 研究糖耐量低减患者血管内皮舒张功能及其与超重和肥胖的关系。方法 采用高分辨率超声测定糖耐量低减伴超重和肥胖患者 (Ⅰ组 )及正常体重患者 (Ⅱ组 )血流介导的肱动脉内皮依赖性血管舒张和硝酸甘油介导的非内皮依赖性血管舒张。结果 糖耐量低减Ⅰ组、Ⅱ组内皮依赖性血管舒张功能较正常对照组降低 (均为P <0 .0 0 1) ;糖耐量低减Ⅰ组较Ⅱ组降低 (P <0 .0 5 ) ;硝酸甘油介导的非内皮依赖性血管舒张各组间无差异 (P >0 .0 5 )。多因素线性相关性分析 ,糖耐量低减患者血管内皮依赖性舒张功能损伤和血糖、甘油三酯、体重指数呈负相关。

Objective To investigate the endothelial dysfunction in patients with impaired glucose tolerance (IGT) and the relationship of overweight. Methods Using high resolution ultrasound, the dilation of brachial artery during reactive hyperaemia (with increased flow causing endothelium-dependent dilatation) and after sublingual Nitroglycerin (NTG, causing endothelium-independent dilation) was measured in 101 subjects: 40 healthy volunteers, 35 impaired glucose tolerance patients with overweight (groupⅠ)and 36 patients without overweight (group Ⅱ). Results In group Ⅰ and group Ⅱ, flow-mediated dilatation (FMD) decreased significantly comparison with the healthy control group ( P <0.001). FMD in group Ⅰ patients was significantly lower than that in group Ⅱ patients ( P <0.01). The dilation by NTG did not differ significantly among three groups ( P >0.05). Multiple regression analysis showed that endothelial dysfunction was significantly correlated with glucose ( r =-0.53, P <0.001), triglyceride(TG) ( r =-0.41, P <0.001) and body mass index(BMI) ( r =-0.22, P <0.01). Conclusion The endothelium-dependent vasodilation in patients with IGT was reduced and became more serious with increase of BMI.