2型糖尿病合并冠心病患者血清脂联素、血皮素-1和一氧化碳与血管内皮功能相关性研究

Association of serum adiponectin, nitric oxide, endothelin-1 and endothelium-dependent vasodilatation in type 2 diabetic patients with coronary heart disease

目的研究糖尿病合并冠心病患者血清脂联素(APN)、一氧化氮(NO)、内皮素(ET-1)、高密度脂蛋白(HDL)、反应性充血肱动脉内径增加程度(FMD)的水平,并分析其相关性,探讨脂联素对内皮功能的影响。方法75例糖尿病患者分为单纯糖尿病组(B组,35例)和合并冠心病组(C组,40例),正常对照(A组)33例,分别检测血清APN、NO、ET-1,同时利用超声检测FMD、硝酸甘油诱发内皮独立的肱动脉直径增加程度(NID)。结果B组、C组与A组比较,血APN、NO、HDL显著降低(P<0.01);FBG、ET-1显著升高(P<0.01)。FMD(%)降低(P<0.05),NID(%)各组间差异无显著性(P>0.05)。APN与ET-1、FBG、BMI呈负相关(r=-0.41,r=-0.49,r=-0.31,P<0.01),与FMD(%)、NO、HDL呈显著正相关(r=0.672,r=0.308,r=0.347,P<0.01)。结论2型糖尿病合并冠心病患者存在明显的内皮功能紊乱,脂联素可通过影响ET-1和NO的释放,改善血管内皮功能。

[Objective] To investigate the association of serum adiponectin （APN）, nitric oxide （NO）, endothelin- 1 （ET-1） and endothelium-dependent vasodilatation in type 2 diabetes patients with coronary heart disease. [Methods] 75 type 2 diabetes patients were divided into two groups：40 patients with coronary heart disease （C group） and 35 patients without coronary heart disease （B group）, 33 normal control people（A group）. The endothelium-dependent flow-mediated dilatation （FMD） of brachial artery was determined with ultrasound, and the levels of APN, ET- 1, NO and HDL in these three groups were measured respectively. [Results] APN, NO, HDLand FMD decreased distinctively in group B and C compared with group A, while ET-1 increased in the two groups. Serum APN level was sigifieantly positively correlated with FMD, NO, HDL, negatively correlated with ET-1 and FBG. [Conclusion] Type 2 diabetes patients with coronary heart disease have serious endothelium dysfunction, adiponectin may prevent vascular endothelium from damage.