[Changes of endothelium-dependent vasodilation in patients with impaired glucose tolerance and type 2 diabetes].
OBJECTIVE
To investigate the changes of endothelium-dependent flow-mediated dilation (FMD) in patients with impaired glucose tolerance (IGT) and Type 2 diabetes (T2DM) and its influencing factors.


METHODS
The patients with IGT and T2DM were divided into IGT group (n=36), T2DM without vascular complication group (DM1;n=57), and T2DM with vascular complication group (DM2;n=31). And 25 normal subjects served as controls (NC group). The FMD was measured by high resolution ultrasound.The serum levels of tumor necrosis factor-alpha (TNF-alpha) and high sensitive C-reactive protein (hs-CRP) were detected with ELISA, and nitric oxide (NO) with Griess Reaction. The serum glucose, lipids, and other indexes were also detected.


RESULTS
Compared with the NC group, the serum levels of triglyceride (TG) total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), hs-CRP, and TNF-alpha significantly increased (P<0.05), but the serum levels of high density lipoprotein-cholesterol (HDL-C), the NO, and FMD significantly decreased (P<0.05) in the IGT, DM1, and DM2 group. With the progress of diabetes, FMD level descended. Pearson correlation analysis showed a negative correlation between FMD and glycosylated hemoglobin (HbA1c), insulin resistant index (HOMA-IR),TG,TC,hs-CRP, and TNF-alpha (P<0.01), but a positive correlation between FMD and NO,HDL-C (P<0.01) in IGT and T2DM patients. In multiple linear stepwise regression with FMD as dependent variable, NO,HbA(1)c,HDL-C,HOMA-IR, TNF-alpha, and hs-CRP showed a significant association with FMD (P<0.01).


CONCLUSIONS
Endothelium-dependent vasodilation is impaired in patients with IGT and T2DM,which is associated with hyperglycaemia, insulin-resistance, hyperlipemia, and inflammation.
Wu
Jing
J
Department of Endocrinology, Xiangya Hospital, Central South University, Changsha 410008, China. wujing0731@hotmail.com
Lei
Min-Xiang
MX
Liu
Lan
L
Huang
Yuan-Jin
YJ
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000503:physiopathology*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014664:Vasodilation
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; D014409:Tumor Necrosis Factor-alpha