2型糖尿病高危人群的血管内皮功能与血浆游离脂肪酸水平

目的研究2型糖尿病（T2DM）患者、糖耐量正常的2型糖尿病一级亲属（FDRs）、糖耐量减低（IGT）人群的血管内皮功能、血浆游离脂肪酸（FFA）水平并与健康对照组进行比较。方法测定36例健康人（男16例,女20例）、57例FDRs（男27例,女30例）、59例IGT（男25例,女34例）,35例T2DM（男15例,女20例）的FFA水平、内皮依赖性血管舒张功能（EDV）以及空腹胰岛素、TC、TG、BMI、腰臀围比、空腹血糖及糖化血红蛋白,同时计算胰岛素敏感性指数（IAI）。结果FDRs、IGT及T2DM组的EDV显著低于健康对照组FDRs组（5．03±0．34）％,IGT组（3．09±0．28）％,T2DM组（2．62±0．29）％,对照组（12．45±3．37）％];FFA水平高于对照组FDRs组（0．52±0．08）mmol／L,IGT组（0．52±0．12）mmol／L,T2DM组（0．59±0．23）mmol／L,对照组（0．46±0．18）mmol／L];IAI低于对照组（FDRs组-4．20±0．38,IGT组-4．41±0．72,T2DM组-4．65±0．64,对照组-3．79±0．57）,差异均有统计学意义（P值均〈0．05）。结论T2DM、糖耐量正常的FDRs及IGT人群存在IAI降低、血管内皮功能受损、FFA升高。

Vascular endothelial function and plasma free fatty acids in the high-risk population of type 2 diabetes

OBJECTIVE: To study the vascular endothelial function and the level of plasma free fatty acids (FFA) in patients with type 2 diabetes mellitus (T2DM), their first degree relatives (FDRs) with normal glucose tolerance and subjects with impaired glucose tolerance (IGT) and to compare these with health control. METHODS: Endothelial-dependent vasodilation (EDV), plasma level of FFA, and insulin active index (IAI) were measured in 36 controls with normal glucose tolerance (16 men and 20 women), 57 FDRs (27 men and 30 women), 59 subjects with IGT (25 men and 34 women) and 35 patients with T2DM (15 men and 20 women). RESULTS: EDV was lower in FDRs, IGT and T2DM than that in the controls FDRs (5.03+/-0.34)%, IGT (3.09+/-0.28)%, T2DM (2.62+/-0.29)%, controls (12.45+/-3.37)%]. The plasma level of FFA was higher in FDRs, IGT and T2DM than that in the controls FDRs (0.52+/-0.08) mmol/L, IGT (0.52+/-0.12) mmol/L, T2DM (0.59+/-0.23) mmol/L, controls (0.46+/-0.18) mmol/L], IAI was lower in FDRs, IGT and T2DM than that in the controls (FDRs -4.20+/-0.38, IGT -4.41+/-0.72, T2DM -4.65+/-0.64, controls -3.79+/-0.57), P<0.05. CONCLUSIONS: There are decreased IAI, impaired endothelial function and increased plasma level of FFA in the FDRs with normal glucose tolerance, subjects with IGT and patients with T2DM.