空腹血糖受损、糖耐量减低人群血管内皮功能及颈动脉内中膜厚度的变化

Changes of Vascular Endothelial Function and Carotid Artery Intima-Media Thickness in Patients with Impaired Fasting Glucose and Impaired Glucose Tolerance

目的:探讨空腹血糖受损(IFG)及糖耐量减低(IGT)人群血管内皮功能和颈动脉内膜中膜厚度(IMT)的变化。方法:81例空腹血糖受损及糖耐量减低人群为观察组,30例空腹血糖(FPG)及餐后2小时血糖(2hPG)正常者为对照组,所有受检者均通过高频超声进行内皮依赖性舒张功能(FMD)和IMT检测。结果:正常对照组、IFG组、IGT组、IFG和IGT并存组的FMD值呈逐渐显著降低(P<0.01),简单相关和多元回归分析显示FMD值与FPG、2hPG和IMT均呈负相关(P均<0.01)。IMT在IGT组和IFG与IGT并存组均显著高于对照组及IFG组(P<0.01),但前两组间及后两组间差异均无统计学意义;多元逐步回归分析显示IMT与FMD有线性回归关系(β=-0.807,P均<0.01),而与FPG和2hPG则均无线性回归关系(β=-0.177、0.090,P均>0.05)。结论:空腹血糖受损及糖耐量减低均可导致血管内皮功能障碍,空腹血糖受损无早期动脉硬化,而糖耐量减低者可出现动脉硬化表现,且其动脉硬化的程度与其血管内皮功能的受损密切相关。

Objective: To explore the changes of vascular endothelial function and carotid artery intima-media thickness (IMT)in patients with impaired fasting glucose and impaired glucose tolerance. Methods: Using high-resolution ultrasonography, brachial artery flow mediated dilation (FMD) and carotid artery IMT were measured in 81 patients with impaired fasting glucose and impaired glucose tolerance, 30 normal glucose tolerance people were respectively observed as the control group. Results: The level of brachial artery FMD showed a progressive reduction among the normal control group, IFG groups, IGT groups, IFG plus IGT groups(P < 0.01). Simple linear correlation analysis and regression analysis showed that there was an obvious negative correlation between FMD and the fasting plasma glucose(FPG) , 2h plasma glucose(2hPG) or IMT(P < 0.01 for all). Compared with the control group and IFG group, the IMT value were significantly increased in IGT groups and IGT plus IFG groups (P < 0.01 for all), but there was no statistical difference between the control group and IFG group or between IGT and IGT plus IFG group. Stepwise regression analysis showed that the IMT was negatively related to the FMD (β=-0.807,P < 0.01), but there were no associations between the IMT values and FPG or 2hPG (β=-0.177、0.090,P > 0.05 for all). Conclusion: Impaired fasting glucose and impaired glucose tolerance could induce endothelial dysfunction. Impaired fasting glucose does not show any impact on the early atherosclerosis, however, impaired glucose tolerance could induce the early atherosclerosis. Meanwhile atherosclerosis is closely correlated with the endothelial dysfunction.