餐后高血糖对肱动脉内皮依赖性舒张功能的影响

目的应用多普勒超声技术检查餐后高血糖患者的血管肉皮功能,探讨餐后高血糖对动脉粥样硬化的影响。方法选择新诊断2型糖尿病患者46例,采集静脉血测TC、TG、LDL-C、HDL-C、血糖、胰岛素、糖化血红蛋白(HbAlc)、高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP),并行口服葡萄糖耐量试验后测餐后2 h血糖(2 h PG)及餐后2 h胰岛素(2 h INS)。将其结果分为空腹高血糖组(空腹高血糖惠者21例)及餐后高血糖组(餐后高血糖患者25例),同期选择血糖正常者20例作为对照组,测定3组的肱动脉内皮依赖性舒张功能(endothelium-dependent dilation,EDD)。结果餐后高血糖组和空腹高血糖组患者肱动脉EDD、TC、LDL-C、HDL-C、空腹血糖、2 h PG、2 h INS、HbAlc、hs-CRP与对照组比较.差异有统计学意义(P<0.05,P<0.01)。餐后高血糖组患者肱动脉EDD较空腹高血糖组明显降低[(3.58±1.04)%vs(4.86±0.92)%.P<0.01]。多因素逐步回归分析显示,EDD与2 h PG、HbAlc、TC呈明显负相关(r分别为-0.77、-0.61、-0.57,P<0.01)。结论餐后高血糖较空腹高血糖对血管内皮功能危害更大.加强餐后高血糖的控制对延缓动脉粥样硬化更为重要。

Effects of postprandial hyperglycemia on brachial artery endothelium-dependent dilation

Objective To observe vascular endothelial function with high-resolution Doppler ultrasonography in patients with postprandial hyperglycemia, and study influence of postprandial hyperglycemia on atherosclerosis. Methods Patients with newly diagnosed type 2 diabetic mellitus were divided into two groups:21 patients with fasting hyperglycemia(FHG group),25 patients with postprandial hyperglycemia(PHG group). Meanwhile 20 normal subjects were chosen as control group. TC, TG, LDL-C, HDL-C, FBG, INS, HbAlc and hs-CRP were measured after overnight fast,2 h PG and 2 h INS were measured two hours after OGTT. Ultrasound evaluation of their brachial artery endothelium-dependent dilation(EDD)was conducted. Results Brachial artery EDD in PHG group was significantly lower than that in FHG group[(3. 58±1.04)% vs (4.86±0.92)%, P < 0. 01]. Stepwise regression analysis showed that EDD was negatively lorrelated to 2 h PG,HbAlc and TC(r=-0. 77,-0. 61,-0. 57,P<0. 01). Conclusion Vascular endothelial function is damaged more severely in PHG group than in FHG group. It is very important to control PHG for delaying atherosclerosis.