不同阶段老年糖尿病患者血管内皮功能差异及大血管保护机制
发布时间：2019-04-23 22:27
【摘要】：目的比较不同阶段老年2型糖尿病(T2DM)患者血管内皮功能差异并探讨大血管保护机制。方法选取糖耐量受损患者97例,T2DM患者290例,选取同期在该院体检的正常糖耐量老年人106例。进一步将T2DM患者分为新诊断的T2DM组(N1组)86例;T2DM达标组(N2组)101例;T2DM未达标组(N3组)103例。超声测定各组内皮依赖的血管扩张率(FMD)、非内皮依赖的血管扩张率(GTN)、颈动脉内膜中层厚度。硝酸还原酶法、酶联免疫吸附(ELISA)法测定一氧化氮(NO)、内皮素(ET)-1含量。分离外周血单个核细胞,荧光定量PCR检测胃蛋白酶原C(PGC)-1αmRNA、白细胞介素(IL)-1 mRNA转录水平;Western印迹检测P-Akt(Ser473)蛋白表达。结果 T2DM组FMD值明显低于正常糖耐量组和糖耐量受损组(P0.05);N2组和N3组GTN值和颈动脉内膜中层厚度均明显低于N1组、正常糖耐量组、糖耐量受损组(P0.05)。N1组基础NO、ET-1水平明显高于其余各组(P0.05)。T2DM组PGC-1αmRNA、IL-1 mRNA表达量均明显高于非T2DM组(P0.05)。T2DM组P-Akt(Ser473)蛋白表达量明显低于正常糖耐量组与糖耐量受损组(P0.05);N1组明显高于N3组(P0.05)。PGC-1αmRNA水平是FMD的独立影响因素;低密度脂蛋白胆固醇(LDL-C)、舒张压是GTN的独立影响因素;收缩压是颈动脉内膜中层厚度的独立影响因素。结论 FMD可敏感预测早期老年T2DM大血管病变,GTN、颈动脉内膜中层厚度偏重于病变进展;PGC-1α基因可经内皮依赖和非依赖两种机制保护糖尿病大血管。
[Abstract]:Objective to compare the vascular endothelial function in elderly patients with type 2 diabetes mellitus (T2DM) at different stages and to explore the protective mechanism of macrovessel. Methods 97 patients with impaired glucose tolerance and 290 patients with T2DM were selected. Patients with T2DM were further divided into newly diagnosed T2DM group (N1 group, n = 86), T2DM group (N2 group, n = 101) and T2DM failure group (N _ 3 group, n = 103). Endothelium-dependent vasodilation rate (FMD),-independent vasodilation rate (GTN), carotid intima-media thickness was measured by ultrasound. Nitric acid reductase method and enzyme-linked immunosorbent assay (ELISA) were used to determine the content of nitric oxide (NO), endothelin (ET)-1. Peripheral blood mononuclear cells were isolated and the expression of P-Akt (Ser473) protein was detected by Western blot and the transcription level of (IL)-1 mRNA of pepsinogen C (PGC)-1 伪 mRNA, IL-(IL)-1 was detected by fluorescence quantitative PCR (FQ-PCR). Results the value of FMD in T2DM group was significantly lower than that in normal glucose tolerance group and impaired glucose tolerance group (P0.05). GTN and carotid intima-media thickness in N2 and N3 groups were significantly lower than that in N1 group, normal glucose tolerance group and impaired glucose tolerance group (P0.05). Basal NO,ET-1 level in N1 group was significantly higher than that in other groups (P0.05). PGC-1 伪 mRNA, in T2DM group was significantly higher than that in other groups (P0.05). The expression of P-Akt (Ser473) protein in T2DM group was significantly lower than that in normal glucose tolerance group and impaired glucose tolerance group (P0.05). The expression of IL-1 mRNA was significantly higher than that in non-T2DM group (P0.05). The levels of PGC-1 伪 mRNA were independent influencing factors of FMD, low density lipoprotein cholesterol (LDL-C) and diastolic blood pressure (DBP) were independent influencing factors of GTN. Systolic blood pressure (SBP) is an independent influencing factor of carotid intima-media thickness. Conclusion FMD can sensitively predict the early senile T2DM macroangiopathy, and the carotid intima-media thickness of GTN, is more important than the progression of the disease, and the PGC-1 伪 gene can protect diabetic macrovessels through both endothelium-dependent and non-dependent mechanisms.
【作者单位】： 临沂市第三人民医院;
【分类号】：R587.1
，
本文编号：2463854
[Abstract]:Objective to compare the vascular endothelial function in elderly patients with type 2 diabetes mellitus (T2DM) at different stages and to explore the protective mechanism of macrovessel. Methods 97 patients with impaired glucose tolerance and 290 patients with T2DM were selected. Patients with T2DM were further divided into newly diagnosed T2DM group (N1 group, n = 86), T2DM group (N2 group, n = 101) and T2DM failure group (N _ 3 group, n = 103). Endothelium-dependent vasodilation rate (FMD),-independent vasodilation rate (GTN), carotid intima-media thickness was measured by ultrasound. Nitric acid reductase method and enzyme-linked immunosorbent assay (ELISA) were used to determine the content of nitric oxide (NO), endothelin (ET)-1. Peripheral blood mononuclear cells were isolated and the expression of P-Akt (Ser473) protein was detected by Western blot and the transcription level of (IL)-1 mRNA of pepsinogen C (PGC)-1 伪 mRNA, IL-(IL)-1 was detected by fluorescence quantitative PCR (FQ-PCR). Results the value of FMD in T2DM group was significantly lower than that in normal glucose tolerance group and impaired glucose tolerance group (P0.05). GTN and carotid intima-media thickness in N2 and N3 groups were significantly lower than that in N1 group, normal glucose tolerance group and impaired glucose tolerance group (P0.05). Basal NO,ET-1 level in N1 group was significantly higher than that in other groups (P0.05). PGC-1 伪 mRNA, in T2DM group was significantly higher than that in other groups (P0.05). The expression of P-Akt (Ser473) protein in T2DM group was significantly lower than that in normal glucose tolerance group and impaired glucose tolerance group (P0.05). The expression of IL-1 mRNA was significantly higher than that in non-T2DM group (P0.05). The levels of PGC-1 伪 mRNA were independent influencing factors of FMD, low density lipoprotein cholesterol (LDL-C) and diastolic blood pressure (DBP) were independent influencing factors of GTN. Systolic blood pressure (SBP) is an independent influencing factor of carotid intima-media thickness. Conclusion FMD can sensitively predict the early senile T2DM macroangiopathy, and the carotid intima-media thickness of GTN, is more important than the progression of the disease, and the PGC-1 伪 gene can protect diabetic macrovessels through both endothelium-dependent and non-dependent mechanisms.
【作者单位】： 临沂市第三人民医院;
【分类号】：R587.1
，
本文编号：2463854
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