胰岛素抵抗对2型糖尿病患者血管内皮舒张功能的影响

Effects of Insulin Resistance on Vascular Endothelial Function in Type 2 Diabetes Mellitus

目的评价2型糖尿病患者的血管内皮舒张功能,探讨胰岛素抵抗(IR)对血管内皮功能的影响。方法2型糖尿病患者分为IR组(24例)和非IR组(21例),另设正常对照组(30例)。采用高分辨率超声检测肱动脉内皮依赖性和非依赖性舒张反应(EDD,EID)。测定空腹血糖(FBG)、空腹胰岛素(FINS)及一氧化氮(NO),并采用稳态模式法计算胰岛素抵抗指数(HOMA-IR)。结果IR组和非IR组糖尿病患者的EDD、EID、NO均明显低于对照组(P<0.01),IR组的EDD、EID、NO明显低于非IR组(P<0.01)。结论2型糖尿病患者的内皮依赖性和非依赖性舒张功能均有受损,胰岛素抵抗是导致损害加重的高度危险因素。

Objective To investigate vascular endothelial function in type 2 diabetic patients and to explore the effects of insulin resistance（IR）on vascular endothelial function. Methods Type 2 diabetic patients were divided into IR group（n=24） and without IR group（n=21） ,and healthy volunteers were enrolled in the normal control group（n=30）. The brachial artery responses to endothelium-dependent dilation（EDD） and endothelium-independent dilation（EID） were measured by high resolution ultrasonography. The fasting blood glucose（FBG）, fasting insulin（FINS）and nitric oxide（NO）were detected. HOMA-IR were calculated. Results EDD,EID,NO decreased obviously in the two groups of diabetes mellitus compared with normal control group（both P〈0.01）. EDD,EID,NO were obviously lower in IR group than those in without IR group（both P〈0.01）. Conclusion Both EDD and EID are severely impaired in type 2 diabetic patients. Insulin resistance are high risk factors in the aggravation of endothelial dysfunction.