长期危险饮酒与脂代谢 糖耐量变化及动脉硬化的关系

Investigation on relationship between jeopardous drinking for long and lipid metabolism,the changes of glucose tolerance as well as arteriosclerosis

目的探讨长期危险饮酒与脂代谢、糖耐量变化及动脉粥样硬化的关系,为长期危险饮酒人群动脉粥样硬化的早期预防及治疗提供依据。方法按世界卫生组织饮酒分类标准和1999年的糖耐量低减标准,从体检中心健康体检者中选出符合以上条件男性96例(A组);根据体检者自愿的原则将A组分为禁酒组(A1组)48例,危险饮酒组(A2组)48例;非饮酒符合糖耐量正常者56例(B组)。先量体检者的收缩压,然后抽取A、B两组体检者的空腹和进食75g葡萄糖的2h血样,空腹血样分别测定空腹胰岛素(FIns)、空腹血糖(FBG)、三酰甘油(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和载脂蛋白A1(ApoA1)的浓度;餐后2h血样分别测定2h血糖(BG)和2h胰岛素(Ins)的浓度;6个月和2年后,以同样的方法测定A1组和A2组血样的相关项目。结果A组体检者血清中的FBG、2hBG、FIns、2hIns、TG、TC、LDL-C的浓度均较B组明显升高,而HDL-C和ApoA1明显下降;6个月后,A1组与A2组及B组相比,脂代谢紊乱和胰岛素抵抗有了明显的改善,糖耐量低减状态明显好转;2年后A1组的所有检测指标基本接近B组水平,而A2组主要表现为高TG和TC及低HDL-C血症、代偿性高Ins血症、胰岛素抵抗,糖耐量状态显著恶化。结论禁酒或控制饮酒量,改变不良生活习惯,并对脂代谢紊乱进行积极的治疗,改善糖耐量状态,可有效控制和延缓动脉粥样硬化的发生和发展。

Objective To explore the relationship between jeopardous drinking for long and lipid metabolism, the changes of glucose tolerance as well as arteriosclerosis, and so as to provide basis for the early prevention and therapy of jeopardous drinking for long induced arteriosclerosis. Methods According to the drinking classification criteria of WHO and the IGT standards in 1999,96 healthy persons [-group A,divided into drinking inhibiting group （group A1 ,n=48） and jeopardous drinking group （group A2 ,n=48）] and 56 non-drinkers （group B） were enrolled in the investigation. Systolic blood pressure （SBP） was measured in advance. Blood samples were collected from all subjects hungry or after orally administration of 75 g glucose. The concentrations of Fins, FBG, TG, TC, HDL-C, LDL-C and ApoA1 were measured for the fasting blood samples, while of 2 h BG and 2 h Ins were measured for 2 hours＇ postprandial blood samples. The related items were measured with the same method for blood samples of group A1 and group A2 6 months and 2 years later. Results As compared with those of group B,the concentrations of FBG,2 h BG,FIns,2 h Ins,TG,TC,and LDL-C in group A were much higher,while HDL-C and ApoA1 much lower. Six months later, lipid metabolic disorder, insulin resistance and impaired glucose tolerance in group A were markedly ameliorated. Two years later, all indicators for group A1 were close to those of group B, while group A2 showed hypertriglyceridemia, hypercholesteremia, hypoalphalipoproteinemia, compensatory hyperinsulinemia, insulin resistance and obvious deterioration of glucose tolerance. Conclusion The occurrence and development of arteriosclerosis can be effectively controlled and postponed by means of temperance or drinking control,a good daily habit and available treatment of lipid metabolic disorder.