Association analysis of genes in the renin‐angiotensin system with subclinical cardiovascular disease in families with Type 2 diabetes mellitus: The Diabetes Heart Study

Aims Cardiovascular disease (CVD) is a major complication of Type 2 diabetes mellitus. The renin‐angiotensin system (RAS) and nitric oxide production are both important regulators of vascular function and blood pressure. Genes encoding proteins involved in these pathways are candidates for a contribution to CVD in diabetic patients. We have investigated variants of the angiotensinogen (AGT), angiotensin converting enzyme (ACE), angiotensin type 1 receptor (AT1R) and endothelial nitric oxide synthase (NOS3) genes for association with subclinical measures of CVD in families with Type 2 diabetes mellitus (T2DM). Methods Atherosclerosis was measured by carotid intima‐media thickness and calcification of the carotid and coronary arteries in 620 European Americans and 117 African Americans in the Diabetes Heart Study. Because of the role of these systems in blood pressure regulation, blood pressure was also investigated. Results Compelling evidence of association was not detected with any of the SNPs with any outcome measures after adjustments for covariates despite sufficient power to detect relatively small differences in traits for specific genotype combinations. Conclusions Genetic variation of the RAS and NOS3 genes do not appear to strongly influence subclinical cardiovascular disease or blood pressure in this diabetic population.     

脑心通对颈动脉粥样硬化症患者临床症状及IMT的影响

目的：观察脑心通胶囊对颈动脉粥样硬化症患者临床症状及颈动脉内膜中层厚度（IMT）的影响。方法：对照组102例单用尼莫地平20mg，每日3次；治疗组102例在对照组基础上加脑心通胶囊2粒（0．8g），每日3次。总疗程3个月，比较两组治疗前后临床症状及IMT情况。结果：治疗组临床症状缓解总有效率93．14％，IMT明显改善，均优于对照组。结论：脑心通治疗颈动脉粥样硬化症有效。     

Long‐chain polyunsaturated fatty acids in infant formula and cardiovascular markers in childhood

To investigate whether children who consumed infant formula supplemented with long‐chain polyunsaturated fatty acids (LCPUFAs) had a more favourable cardiovascular profile than children who consumed formula without these fatty acids, we used the Wheezing Illnesses Study Leidsche Rijn, a birth cohort that included 2,468 newborns between 2001 and 2014. Data on infant feeding were obtained by questionnaires. At age 5, blood pressure, carotid intima‐media thickness (CIMT), and carotid distension were measured. We used multivariable linear regression analysis to compare levels of cardiovascular markers in formula‐fed children born before and after the LCPUFA supplementation. To account for secular trends, we compared levels of cardiovascular markers in a control group of breastfed children from the same cohort born before and after the supplementation. Formula‐fed children born after the LCPUFA supplementation (n = 48) had no different systolic blood pressure (?2.58 mmHg, 95% confidence interval, CI [?5.5, 0.30]), diastolic blood pressure (?0.13 mmHg, 95% CI [?2.3, 2.1]), or carotid distension (24.8 MPa^?1, 95% CI [?47.1, 96.6]) and had a higher CIMT (18.6 μm, 95% CI [3.7, 33.5]) than formula‐fed children born before the supplementation (n = 163). In the control group, children born after the LCPUFA supplementation (n = 98) had no different systolic‐ or diastolic‐blood pressure, or CIMT, and a higher carotid distension than children born before the supplementation (n = 142). In conclusion, children who consumed infant formula supplemented with LCPUFAs did not have a more favourable cardiovascular profile in early childhood than children who consumed formula without LCPUFAs.     

血清同型半胱氨酸水平与颈动脉粥样硬化的关系探讨

目的 探讨血清同型半胱氨酸水平(Hcy)与颈动脉粥样硬化程度的关系.方法 选择住院治疗的82例缺血性脑卒中患者,经彩色多普勒B超检查的结果分为颈动脉正常组、颈动脉内膜-中层增厚组、颈动脉粥样硬化斑块组,并测定血清同型半胱氨酸水平,进行组间比较.结果 颈动脉粥样硬化斑块组的血清同型半胱氨酸水平明显高于颈动脉正常组及颈动脉内膜-中层增厚(IMT)组,差异有统计学意义(P＜0.05);颈动脉内膜-中层增厚组与颈动脉正常组血清同型半胱氨酸水平比较,差异有统计学意义(P＜0.05).结论 血清同型半胱氨酸水平高低与颈动脉粥样硬化程度呈正相关,血清同型半胱氨酸水平(Hcy)越高,颈动脉粥样硬化斑块、狭窄越严重.     

应用血管回声跟踪技术对2型糖尿病患者股动脉血管弹性及血流动力学的研究

目的探讨2型糖尿病患者股动脉血管弹性及下肢血流动力学的变化。方法 应用血管回声跟踪（echo-tracking,ET）技术,采集30例正常人和54例2型糖尿病患者的股动脉的二维超声图像,测量双侧股动脉内中膜厚度（IMT）;应用脉冲多普勒技术（PW）测量股动脉血流阻力指数（RI）、搏动指数（PI）;应用ET技术检测弹性指标β。结果按照IMT是否〈1.0mm分组后显示：糖尿病IMT〈1.0mm组及糖尿病IMT≥1.0mm组的股动脉血流动力学参数RI、PI及弹性指标β均较对照组差异有统计学意义（P〈0.05）;糖尿病IMT≥1.0mm组的股动脉血流动力学参数RI、PI及弹性指标β较糖尿病IMT〈1.0mm组差异有统计学意义（P〈0.05）。结论糖尿病患者下肢动脉在动脉粥样硬化的形态学改变出现之前,血管壁弹性功能已降低,且影响血流动力学,有可能造成外周组织血液供应不良。     

阿托伐他汀钙对血脂异常高血压患者血脂及颈动脉内膜-中膜厚度的影响

目的探讨阿托伐他汀钙对血脂异常高血压病患者的调脂作用及对颈动脉内膜-中膜厚度(IMT)的影响。方法将350例血脂异常高血压病患者随机分为对照组170例与观察组180例,对照组常规降压治疗,观察组患者在常规治疗基础上给予阿托伐他汀片口服。比较两组治疗后血压、血脂及IMT的差异。结果治疗后两组血压无显著性差异(P>0.05),观察组甘油三酯(TG)、总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)水平均显著低于对照组(P<0.05);与对照组相比,治疗后观察组IMT值显著下降(P<0.05)。结论阿托伐他汀可显著降低血脂异常高血压患者血脂水平,延缓甚至逆转颈动脉粥样硬化斑块。     

辛伐他汀对高脂血症患者颈动脉内膜-中层厚度及凝血系统的影响

目的 :观察辛伐他汀对高脂血症患者颈动脉内膜 中层厚度 (IMT)及凝血系统的变化及其非调脂作用 .方法 :高脂血症患者 4 6例口服辛伐他汀 2 0mg ,Qd ,12wk ,分别于治疗前后观察IMT、血脂总胆固醇 (TC)、三酰甘油 (TG)、低密度脂蛋白胆固醇 (LDL C)、高密度脂蛋白胆固醇 (HDL C)、纤维蛋白原 (FIB)、凝血酶原时间 (TT)、活化部分凝血酶时间(APTT)、凝血酶原时间 (PT)改变 .结果 :血脂紊乱组治疗 12wk后的颈动脉IMT变薄 (P <0 .0 0 1) ;TC ,TG ,LDL C ,FIB均有显著降低 (P <0 .0 0 1) ,HDL C升高 (P <0 .0 0 1) ,TT ,APTT均有显著延长 (P <0 .0 0 1) .PT升高 (P <0 .0 0 1) .结论 :调脂作用的辛伐他汀有效调脂同时可发挥其非调脂作用 ,干预、延迟颈动脉IMT的进程 ,改善凝血系统 ,减低血液黏稠度 .     

西格列汀联合二甲双胍治疗2型糖尿病伴心血管疾病患者的疗效观察及对IMT、Hcy水平、血流动力学的影响

目的:探究西格列汀联合二甲双胍治疗2型糖尿病伴心血管疾病患者的疗效观察及对IMT、Hcy水平、血流动力学的影响.方法:2012年6月~2015年7月收治的180例确诊为2型糖尿病合并心血管疾病的患者,根据随机数字表法,平均分为观察组及对照组,每组90例.比较两组患者血糖(FBG),糖化血红蛋白(HbA1c)、空腹胰岛素(FIN)、胰岛素抵抗指数(HOMA-IR)、颈动脉内膜中层厚度(IMT),同型半胱氨酸(Hcy)水平,球后血流动力学水平.结果:治疗后观察组与对照组的FBG、HbA1c、FIN、HOMA-IR均明显改善,观察组患者FBG、HbA1c、FIN水平较对照组改善更为明显;观察组患者IMT、Hcy水平明显下降,且显著低于对照组;两组患者视网膜中央动脉(CRA),睫状后动脉(PCA)的血流速度均较治疗前有明显改善,且观察组上述指标明显高于对照组.结论:西格列汀联合二甲双胍治疗2型糖尿病可有效降低各血糖指标的同时降低IMT及Hcy含量,增强眼底微循环,明显改善糖尿病血管病变,值得临床推广.     

Impact of Regular Physical Activity on Adipocytokines and Cardiovascular Characteristics in Spinal Cord–Injured Subjects

Objective

To investigate the relationship of carotid artery intima-media thickness (IMT) and cardiac structure and function with adipocytokines in sedentary (S-SCI) and physically active (PA-SCI) subjects with spinal cord injury (SCI).

脑梗死患者胰岛素抵抗与CRP,HCY,FIB水平、颈动脉IMT的相关性研究

目的 探讨脑梗死患者胰岛素抵抗(Insulin resistance,IR)与C反应蛋白(C-reactive protein,CRP)、同型半胱氨酸(Homocysteine,HCY)、血浆纤维蛋白原(Fibrinogen,FIB)水平、颈动脉内膜中层厚度(Inteima-media thickness,IMT)的相关性。方法 选择2014年1月-2015年1月入住本院神经内科的脑梗死患者260例纳入观察组,选择同期于本院进行健康体检志愿者260例纳入对照组; 观察组患者入院后24 h内检测空腹血糖(Fasting blood glucose,FBG)、总胆固醇(Total cholesterol,TC)、甘油三酯(Triglyceride,TG)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(High density liptein cholesterol,HDL-C)、空腹胰岛素(Fasting insulin,FINS)及外周血CRP,HCY,FIB水平; 计算胰岛素抵抗指数(Homa-insulin resistance index,HOMA-IR); 对照组同期进行上述指标水平检测; 按照是否发生IR将观察组分为IR组、非IR组,比较各组上述指标水平; 以Pearson相关分析评价HOMA-IR与其他各项指标水平的相关性。结果 观察组血清FBG,TC,TG,LDL-C,FINS及外周血CRP,HCY,FIB水平及IMT,HOMA-IR均高于对照组,血清HDL-C水平低于对照组(P<0.05); IR组血清FBG,TC,TG,LDL-C,FINS及外周血CRP,HCY,FIB水平及IMT,HOMA-IR均高于非IR组,血清HDL-C水平低于非IR组(P<0.05); 经Pearson相关分析显示,HOMA-IR与TC,TG,LDL-C,HDL-C水平无相关性(P>0.05),与FBG,FINS,CRP,HCY,FIB水平、IMT增加呈正相关(0.3<r<0.6,P<0.05)。结论 脑梗死患者胰岛素抵抗与CRP,HCY,FIB水平、颈动脉IMT增加呈正相关。