短期胰岛素泵强化治疗对2型糖尿病患者内皮依赖性血管舒张功能的影响

目的 探讨短期胰岛素泵强化治疗对合并及不合并有大血管并发症的2型糖尿病(T2DM)患者内皮依赖性血管舒张功能(FMD)的影响.方法 选择T2DM患者76例(T2DM组),分为两个亚组,合并有大血管并发症者28例(T2DM1组),无大血管并发症者48例(T2DM2组),另选年龄、性别相匹配的健康对照者30例(NC组),所有对象均接受高频超声检测肱动脉血管FMD,T2DM组经胰岛素泵强化治疗后复查.同时检测血糖、血脂、空腹胰岛素及其他代谢指标,并计算稳态模型法胰岛素抵抗指数(HOMA-IR).结果 与NC组比较,T2DM组患者FMD显著下降(P＜0.01),而糖化血红蛋白(HbA1c)、空腹血糖(FPG)、HOMA-IR、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆同醇(LDL-C)显著增高(P＜0.01或＜0.05).相关分析显示FMD与HbAI1c、FPG、HOMA-IR、TG、LDL-C呈负相关(P＜0.01).与高密度脂蛋白胆同醇(HDL-C)呈正相关(P＜0.01).T2DM组经胰岛素泵强化治疗2周后.两个亚组患者FMD改善效果不同,T2DMl组由治疗前(4.25±1.96)%增至治疗后(4.96±1.36)%(P＞0.05),T2DM2组由治疗前(4.02±2.35)%增至治疗后(7.56±2.34)%(P＜0.01).结论 短期胰岛素泵强化治疗能明显改善不合并有大血管并发症T2DM患者的FMD.

Abstract：

Objective To investigate the effects of short term insulin pump intensive therapy on flow-mediated dilation (FMD) in type 2 diabetes mellitus (T2DM) patients with and without vascular complications. Methods Seventy-six patients with T2DM (T2DM group) were divided into 2 subgroups: T2DM1 subgroup (28 patients with vascular complications) and T2DM2 subgroup (48 patients without vascular complications). Meanwhile, 30 healthy cases were selected as NC group. All research subjects accepted high-frequency ultrasound detection on brachial artery for FMD. After insulin pump intensive therapy,FMD in T2DM group was reexamined, fasting insulin was detected and HOMA-IR was calculated. Results Compared with that in NC group, FMD in T2DM group was significantly lower(P＜ 0.01). However, glycosylated hemoglobin (HbA1c ), fasting plasma glucose (FPG ),H0MA-IR and blood fat were significantly higher (P＜0.01 or ＜0.05). Correlation analysis showed that FMD had negative correlation with HbA1c, FPG, HOMA-IR, triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C)(P＜0.01),and had positive correlation with high-density lipoprotein cholesterol (HDL-C). After 2 weeks of insulin pump therapy, the improvement of FMD between the two groups was different. FMD in T2DM1 subgroup increased from (4.25 ± 1.96)% to (4.96 ± 1.36)%(P＞0.05), and FMD in T2DM2 subgroup increased from (4.02 ± 2.35)% to (7.56 ± 2.34)%(P＜ 0.01). Conclusion Insulin pump intensive therapy can evidently improve FMD in T2DM patients without vascular complications.

Effects of short term insulin pump therapy on endothelia-dependant flow-mediated dilation in type 2 diabetes mellitus patients

Objective To investigate the effects of short term insulin pump intensive therapy on flow-mediated dilation (FMD) in type 2 diabetes mellitus (T2DM) patients with and without vascular complications. Methods Seventy-six patients with T2DM (T2DM group) were divided into 2 subgroups: T2DM1 subgroup (28 patients with vascular complications) and T2DM2 subgroup (48 patients without vascular complications). Meanwhile, 30 healthy cases were selected as NC group. All research subjects accepted high-frequency ultrasound detection on brachial artery for FMD. After insulin pump intensive therapy,FMD in T2DM group was reexamined, fasting insulin was detected and HOMA-IR was calculated. Results Compared with that in NC group, FMD in T2DM group was significantly lower(P＜ 0.01). However, glycosylated hemoglobin (HbA1c ), fasting plasma glucose (FPG ),H0MA-IR and blood fat were significantly higher (P＜0.01 or ＜0.05). Correlation analysis showed that FMD had negative correlation with HbA1c, FPG, HOMA-IR, triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C)(P＜0.01),and had positive correlation with high-density lipoprotein cholesterol (HDL-C). After 2 weeks of insulin pump therapy, the improvement of FMD between the two groups was different. FMD in T2DM1 subgroup increased from (4.25 ± 1.96)% to (4.96 ± 1.36)%(P＞0.05), and FMD in T2DM2 subgroup increased from (4.02 ± 2.35)% to (7.56 ± 2.34)%(P＜ 0.01). Conclusion Insulin pump intensive therapy can evidently improve FMD in T2DM patients without vascular complications.