糖尿病前期和2型糖尿病与普遍的微血管功能障碍有关:马斯特里赫特研究
Ben M Sörensen1, Alfons J H M Houben1, Tos T J M Berendschot1
1From the CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (B.M.S., A.J.H.M.H., A.A.K., C.J.H.v.d.K., R.M.A.H., S.J.S.S., P.C.D., N.C.S., M.T.S., C.D.A.S.); Department of Internal Medicine, Maastricht University Medical Center+, The Netherlands (B.M.S., A.J.H.M.H., A.A.K., C.J.H.v.d.K., R.M.A.H., S.J.S.S., N.C.S., M.T.S., C.D.A.S.); CAPHRI School for Public Health and Primary Care, Maastricht University, The Netherlands (A.K., P.C.D., N.C.S.); Department of Epidemiology, Maastricht University, The Netherlands (P.C.D.); Department of Social Medicine, Maastricht University, The Netherlands (A.K.); and University Eye Clinic Maastricht, Maastricht University Medical Center+, The Netherlands (T.T.J.M.B., J.S.A.G.S.).
影响视网膜和皮肤的微血管功能障碍存在于糖尿病前期,并且在2型糖尿病 (T2DM) 中恶化. 这种损伤与高血糖有关,并可能导致T2DM患者的心血管疾病.
科学领域:
- 血管生物学和代谢疾病研究.
背景情况:
- 2型糖尿病 (T2DM) 显著增加心血管疾病 (CVD) 的风险,部分原因是大动脉功能障碍甚至存在于糖尿病前期.
- 在糖尿病前期和T2DM中微血管功能障碍的存在和严重程度尚不清楚.
研究的目的:
- 研究正常葡萄糖代谢,糖尿病前期和T2DM患者的微血管功能.
- 确定在糖尿病前期是否存在微血管功能障碍,并在T2DM中恶化,支持微血管的"滴答时钟假说".
主要方法:
- 马斯特里赫特研究对2213名参与者 (51%为男性,年龄约60岁) 进行了丰富的T2DM流行,评估了微血管功能.
- 测量包括闪光引起的视网膜动脉扩张和热引起的皮肤高血压,以及通过口服葡萄糖耐受性测试的葡萄糖代谢状态.
- 用多变量回归分析调整了许多临床和人口因素.
主要成果:
- 与正常葡萄糖代谢 (3. 4 ± 2. 8%) 相比,视网膜动脉扩张在糖尿病前期减少 (3. 0± 2.7%) 并进一步减弱T2DM (P=0. 001).
- 皮肤高血症也呈现逐渐下降:正常 (1235±810),糖尿病前期 (1109±748) 和T2DM (937±683),具有显著的趋势 (P=0.001).
- 较高的HbA1c和空腹血糖水平独立地与视网膜动脉扩张和皮肤高血症有关.
结论:
- 糖尿病前期和T2DM独立地与视网膜和皮肤的微血管功能受损有关.
- 这些发现表明微血管功能障碍在T2DM相关的心血管疾病和其他并发症之前,可能源于微血管问题.
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