不同階段老年糖尿病患者血管內(nèi)皮功能差異及大血管保護(hù)機(jī)制
發(fā)布時間：2019-04-23 22:27
【摘要】：目的比較不同階段老年2型糖尿病(T2DM)患者血管內(nèi)皮功能差異并探討大血管保護(hù)機(jī)制。方法選取糖耐量受損患者97例,T2DM患者290例,選取同期在該院體檢的正常糖耐量老年人106例。進(jìn)一步將T2DM患者分為新診斷的T2DM組(N1組)86例;T2DM達(dá)標(biāo)組(N2組)101例;T2DM未達(dá)標(biāo)組(N3組)103例。超聲測定各組內(nèi)皮依賴的血管擴(kuò)張率(FMD)、非內(nèi)皮依賴的血管擴(kuò)張率(GTN)、頸動脈內(nèi)膜中層厚度。硝酸還原酶法、酶聯(lián)免疫吸附(ELISA)法測定一氧化氮(NO)、內(nèi)皮素(ET)-1含量。分離外周血單個核細(xì)胞,熒光定量PCR檢測胃蛋白酶原C(PGC)-1αmRNA、白細(xì)胞介素(IL)-1 mRNA轉(zhuǎn)錄水平;Western印跡檢測P-Akt(Ser473)蛋白表達(dá)。結(jié)果 T2DM組FMD值明顯低于正常糖耐量組和糖耐量受損組(P0.05);N2組和N3組GTN值和頸動脈內(nèi)膜中層厚度均明顯低于N1組、正常糖耐量組、糖耐量受損組(P0.05)。N1組基礎(chǔ)NO、ET-1水平明顯高于其余各組(P0.05)。T2DM組PGC-1αmRNA、IL-1 mRNA表達(dá)量均明顯高于非T2DM組(P0.05)。T2DM組P-Akt(Ser473)蛋白表達(dá)量明顯低于正常糖耐量組與糖耐量受損組(P0.05);N1組明顯高于N3組(P0.05)。PGC-1αmRNA水平是FMD的獨(dú)立影響因素;低密度脂蛋白膽固醇(LDL-C)、舒張壓是GTN的獨(dú)立影響因素;收縮壓是頸動脈內(nèi)膜中層厚度的獨(dú)立影響因素。結(jié)論 FMD可敏感預(yù)測早期老年T2DM大血管病變,GTN、頸動脈內(nèi)膜中層厚度偏重于病變進(jìn)展;PGC-1α基因可經(jīng)內(nèi)皮依賴和非依賴兩種機(jī)制保護(hù)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 偽 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 偽 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 偽 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 偽 gene can protect diabetic macrovessels through both endothelium-dependent and non-dependent mechanisms.
【作者單位】： 臨沂市第三人民醫(yī)院;
【分類號】：R587.1
，
本文編號：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 偽 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 偽 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 偽 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 偽 gene can protect diabetic macrovessels through both endothelium-dependent and non-dependent mechanisms.
【作者單位】： 臨沂市第三人民醫(yī)院;
【分類號】：R587.1
，
本文編號：2463854
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