冠動脈循環器機能不全は,インスリン抵抗性,グルコース耐性障害,および2型糖尿病である
John O Prior1, Manuel J Quiñones, Miguel Hernandez-Pampaloni
1Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, Calif 90095-6948, USA.
Circulation
|April 27, 2005
まとめ
冠動脈内皮機能不全は,インスリン抵抗性や炭水化物不耐性が増加すると悪化する. この酸化窒素による血管運動障害は,糖尿病に関連する心血管疾患の重要な要因です.
科学分野:
- 心血管生理学 心血管の生理学
- メタボリックシンドローム
- 内皮機能の機能について
背景:
- 冠動脈内皮細胞の異常反応は,糖尿病における心血管疾患に関連しています.
- インスリン抵抗性は,冠動脈循環に影響を与える可能性のあるスペクトルです.
- これらの変化を理解することは,糖尿病の心血管リスクの管理に不可欠です.
研究 の 目的:
- インスリン抵抗性のスペクトル全体にわたる冠動脈循環異常を調査します.
- これらの異常の重度が高度なインスリン抵抗性と相関するかどうかを判断します.
- グルコース代謝との関係で,内皮に依存したおよび独立した血管運動を評価する.
主な方法:
- 心筋血流 (MBF) は,ポジトロン放出トモグラフィと13N-アンモニアを用いて評価された.
- 冠動脈機能は,薬理学的血管拡張 (全血管拡張能力) と冷圧器検査 (内皮に依存した血管運動) を通じて評価される.
- 研究には,インスリン感受性 (IS) の個人,インスリン抵抗性 (IR),グルコース耐性障害 (IGT),高血圧または無高血圧の2型糖尿病 (DM) を含む.
主要な成果:
- 総血管拡張能力は,ノルモグリセミック群 (IS,IR,IGT) で類似したが,ノルモテンシブ (-17%) と高血圧 (-34%) のDM患者で低下した.
- 内皮に依存する血管運動は,IRにおいて有意に減少した (-56%) と,IGTおよびDM患者においてさらに減少した (-85%から-120%).
- 酸化窒素による血管運動は,インスリン抵抗性および炭水化物不耐症の重度が増加するにつれて漸進的な低下を示した.
結論:
- 機能的冠動脈循環の異常,特に酸化窒素による血管運動では,インスリン抵抗性や炭水化物不耐性が増加するにつれて徐々に悪化します.
- 減弱した全血管拡張能力は,糖尿病におけるより臨床的に明らかな代謝異常と関連しています.
- これらの発見は,冠動脈内皮機能と心血管の健康にインスリン抵抗性の有害な影響を強調しています.
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