Ravikumar Radhakrishnan, Deepa Raj, Shanthirani Coimbatore, Mohan Viswanathan
Madras Diabetes Research Foundation, Gopalapuram, Chennai, India.
Am J Cardiol. 2002 Oct 1;90(7):702-7. doi: 10.1016/s0002-9149(02)02593-6.
This study compares flow-mediated dilation (FMD) and the augmentation index (AI) in diabetic and nondiabetic subjects and correlates these measurements with carotid intima-media thickness (IMT). Fifty diabetic subjects and 50 age- and sex-matched nondiabetic control subjects were recruited from the Chennai Urban Population Study. IMT of the common carotid artery and FMD of the brachial artery were determined using high-resolution B-mode ultrasonography. AI was measured using the Sphygmocor apparatus. The mean AI of diabetic subjects was significantly higher than the nondiabetic subjects (27.48 +/- 7.41% vs 19.10 +/- 8.19%, p <0.0001). The FMD values were significantly lower among diabetic subjects compared with the nondiabetic subjects (2.1 +/- 2.95% vs 6.64 +/- 4.38%, p <0.0001). At any given age point, diabetic subjects had significantly higher AI and lower FMD values compared with nondiabetic subjects (p <0.05). In the total population, AI and FMD showed a correlation with age (p <0.001), fasting plasma glucose (p <0.01), glycosylated hemoglobin (p = 0.001), and IMT (p = 0.001). Among the nondiabetic subjects, FMD and AI showed a strong correlation with IMT. FMD also showed a strong correlation with age and systolic blood pressure, whereas AI showed a correlation with fasting plasma glucose in diabetic subjects. AI and FMD values showed a strong correlation with age. AI values increased and FMD values decreased with an increase in quartiles of IMT both in diabetic and nondiabetic subjects. Multivariate linear regression analyses in the total study population showed that age and glycosylated hemoglobin were the risk factors associated with AI and FMD, in addition to diastolic blood pressure with AI. Diabetic patients have decreased FMD and increased arterial stiffness compared with age- and sex-matched nondiabetic subjects. These functional changes correlate well with the structural changes of the arteries measured by IMT.
本研究比较了糖尿病患者和非糖尿病患者的血流介导的血管舒张功能（FMD）和增强指数（AI），并将这些测量结果与颈动脉内膜中层厚度（IMT）相关联。从金奈城市人口研究中招募了50名糖尿病患者和50名年龄及性别匹配的非糖尿病对照者。使用高分辨率B型超声测定颈总动脉的IMT和肱动脉的FMD。使用Sphygmocor设备测量AI。糖尿病患者的平均AI显著高于非糖尿病患者（27.48±7.41%对19.10±8.19%，p<0.0001）。与非糖尿病患者相比，糖尿病患者的FMD值显著更低（2.1±2.95%对6.64±4.38%，p<0.0001）。在任何给定年龄点，与非糖尿病患者相比，糖尿病患者的AI显著更高，FMD值更低（p<0.05）。在总人群中，AI和FMD与年龄（p<0.001）、空腹血糖（p<0.01）、糖化血红蛋白（p=0.001）和IMT（p=0.001）相关。在非糖尿病患者中，FMD和AI与IMT呈强相关。FMD还与年龄和收缩压呈强相关，而在糖尿病患者中，AI与空腹血糖相关。AI和FMD值与年龄呈强相关。在糖尿病患者和非糖尿病患者中，随着IMT四分位数的增加，AI值升高，FMD值降低。在整个研究人群中进行的多变量线性回归分析表明，除了舒张压与AI相关外，年龄和糖化血红蛋白是与AI和FMD相关的危险因素。与年龄及性别匹配的非糖尿病患者相比，糖尿病患者的FMD降低，动脉僵硬度增加。这些功能变化与通过IMT测量的动脉结构变化密切相关。
