The Change Of Endothelium-dependent Vasodilatation In Patients With Early Glucose Abnormality

Objective:To observe the change of the endothelium-dependent vasodilatation and serum SOD,MAD,hsCRP,sVCAM-1 in the patients with Impaired glucose tolerance(IGT),type 2 Diabetes mellitus,and the relationship of insulin resistance among these groups.Methods:30 IGT patients,30 type 2 Diabetes mellitus and 33 normal subjects were divided into 3groups.Glucose(FPG),insulin(FINS),Superoxide dismutase(SOD),Maleic Dialdehyde(MDA),high sensitive C-reactive protein(hsCRP),Soluble vascular cell adhesion molecule-1(sVCAM-1) were measured after a 12-hour overnight fast. Then took 75g glucose(OGTT),measured 2hPG.The inner diameter of brachial artery was assessed by a high -resolution ultrasound system before and after reactive hyperemia.Endothelium-dependent flow-mediated dilation (EDF) was calculated as the percent change in brachial artery diameter 1 min after reactive hyperemia compared with baseline. Results:(1) In the IGT group and DM group ,EDF were significantly lower than that of the NGT group(P<0.01;P<0.01),the DM group was significantly lower than that of the IGT group (P<0.01).(2) SOD in the IGT group and DM group were significantly lower than that of the NGT group(P<0.01;P<0.01),but MDA were significantly higher than that of the NGT group(P<0.01;P<0.01),Compared with the IGT group ,SOD in DM group was significantly lower(P<0.01), but MDA was significantly higher(P<0.01).(3) hsCRP was progressively ascenting in the NGT,IGT,DM groups,The comparison between two groups was significantly higher(P<0.01).(4)sVCAM-1 was progressively ascenting in the NGT,IGT,DM groups.IGT group andDM group were significantly higher(P<0.01) than that of the NGT group,The DMgroup was significantly higher(p<0.01) than that of IGT group.(5) Stepwise regression analysis showed that in NGT group EDF was positively relatedto SOD ( r=0.468,P<0.05 ) ; in IGT group EDF was positively related toHOMA-IR(r=-0.472,P<0.05) ; in DM group EDF was positively related tohsCRP(r=-0.460,P<0.01),and positively related to HOMA-IR (r=-0.414,P<0.05),buthad no relationship with other factors.Conclusion:l.EDF is impaired in IGT,type 2 Diabetes Mellitus.2.Insulin resistance is related to the injury of EDF in IGT,type 2 Diabetes Mellitus.3.S0D,MDA,hsCRP,sVCAM-l possibly attend the injury of endothelium cells inIGT> type 2 Diabetes Mellitus.Thus the early diagonosis and early therapy in IGT>type 2 DM patients are very important.