糖代谢异常对肱动脉内皮功能及颈动脉内-中膜厚度影响的研究

Effect of abnormal glucose metabolism on brachial artery endothelial function and carotid intima-media thickness

目的探讨糖代谢异常对肱动脉内皮功能及颈动脉内-中膜厚度(CIMT)的影响。方法将128例新诊断轻、中度高血压患者根据75g OGTT结果分为糖耐量正常(NGT)组39例、IGR组42例和T2DM组47例,检测各组FPG、2hPG、FIns、2hIns、HbA1c、血脂、高敏C反应蛋白(hsC-RP)、胱抑素C(Cys-C)、肱动脉内皮功能和CIMT。结果 NGT、IGR、T2DM组肱动脉内皮依赖性舒张功能(EDD)两两比较差异有统计学意义[(7.64±0.96)%vs(5.85±0.92)%,(7.64±0.96)%vs(4.22±0.86)%,(5.85±0.92)%vs(4.22±0.86)%,P<0.05或P<0.01]。T2DM组CIMT与NGT、IGR组比较差异有统计学意义[(0.89±0.07)vs(1.20±0.09)mm,(0.96±0.12)vs(1.20±0.09)mm,P<0.05]。Logistic多元逐步回归分析结果显示,EDD与FPG、2hPG、2hIns、HbA1c和Cys-C呈负相关,CIMT与TC、TG和LDL-C呈正相关(P<0.05)。结论在NGT-IGR-T2DM发展过程中,肱动脉EDD逐渐减退,CIMT逐渐增加。

Objective To evaluate the effect of abnormal glucose metabolism on brachial artery endothelial function and carotid intima-media thickness （CIMT）. Methods A total of 128 subjects were divided into three groups：39 cases in normal glucose tolerance （NGT） group, 42 cases in IGR group, and 47 cases in T2DM group. FPG, 2 hPG, Fins, 2 hIns, HbA1 c, blood lipids, high-sensitivity C-reactive protein （hsC-RP） and cystatin C （Cys-C） were measured in each group. Ultrasound was used to test their brachial artery endothelial function and CIMT. Results The differences in brachial artery endothelium-dependent dilation （EDD） were statistically significant among the NGT group, IGR group and T2DM group [ （7.64±0.96） vs （5.85±0. 92）,（7.64±0.96） vs （4.22±0.86）,（5.85±0.92） vs （4.22±0.86）,P〈0.05 or P〈0.01]. CIMT was significantly in T2DM group higher than in NGT or IGR group [（0.89±0. 07） vs （1.20±0.09）, （0. 96±0.12） vs （1.20±0.09）, P〈0.05]. Stepwise logistic regression analysis showed that EDD was negatively related to FPG, 2 hPG, 2 bins, HbAlc and Cys-C, while CIMT was positively related to TC,TG and LDL-C （P〈0. 05）. Conclusion In the progress from NGT to IGR to T2DM, brachial artery EDD decreases and CIMT increases gradually.