Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, 650 Charles E. Young Drive South, B2-085J CHS, Box 95648, Los Angeles, CA 90095-6948, USA.
Eur Heart J. 2009 Dec;30(24):3064-73. doi: 10.1093/eurheartj/ehp482.
To examine a relationship between alterations of structure and function of the arterial wall in response to glucose-lowering therapy in type 2 diabetes mellitus (DM) after a 1-year follow-up (FU).
In DM (n = 22) and in healthy controls (n = 17), coronary artery calcification (CAC) was assessed with electron beam tomography and carotid intima-media thickness (IMT) with ultrasound, whereas coronary function was determined with positron emission tomography-measured myocardial blood flow (MBF) at rest, during cold pressor testing (CPT), and during adenosine stimulation at baseline and after FU. The decrease in plasma glucose in DM after a mean FU of 14 +/- 1.9 months correlated with a lower progression of CAC and carotid IMT (r = 0.48, P < or = 0.036 and r = 0.46, P < or = 0.055) and with an improvement in endothelium-related DeltaMBF to CPT and to adenosine (r = 0.46, P < or = 0.038 and r = 0.36, P < or = 0.056). After adjusting for metabolic parameters by multivariate analysis, the increases in DeltaMBF to CPT after glucose-lowering treatment remained a statistically significant independent predictor of the progression of CAC (P < or = 0.001 by one-way analysis of variance).
In DM, glucose-lowering treatment may beneficially affect structure and function of the vascular wall, whereas the observed improvement in endothelium-related coronary artery function may also mediate direct preventive effects on the progression of CAC.
在为期 1 年的随访（FU）后，研究 2 型糖尿病（DM）患者中动脉壁结构和功能改变与降糖治疗之间的关系。
在 DM（n = 22）和健康对照组（n = 17）中，通过电子束断层扫描评估冠状动脉钙化（CAC），通过超声评估颈动脉内膜中层厚度（IMT），同时在 FU 前后，通过正电子发射断层扫描测量静息、冷加压试验（CPT）和腺苷刺激时的心肌血流（MBF）来确定冠状动脉功能。DM 患者在 FU 后平均 14 +/- 1.9 个月时的血浆葡萄糖降低与 CAC 和颈动脉 IMT 的进展减缓相关（r = 0.48，P < or = 0.036 和 r = 0.46，P < or = 0.055），与内皮相关的 CPT 和腺苷刺激下的 DeltaMBF 改善相关（r = 0.46，P < or = 0.038 和 r = 0.36，P < or = 0.056）。通过多元分析调整代谢参数后，降糖治疗后 CPT 下 DeltaMBF 的增加仍然是 CAC 进展的统计学上显著的独立预测因素（方差分析单向分析 P < or = 0.001）。
在 DM 中，降低血糖治疗可能有益地影响血管壁的结构和功能，而观察到的内皮相关冠状动脉功能的改善也可能介导对 CAC 进展的直接预防作用。
