Department of Medicine, Wolfson Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Diabetes Metab Res Rev. 2010 Jul;26(5):365-70. doi: 10.1002/dmrr.1086.
Glucose intolerance produces structural and functional changes in the arterial wall. The present study investigated association between glucose tolerance status and arterial stiffness in subjects with normal and impaired glucose regulation (IGR).
The study group consisted of 284 subjects, including 111 subjects with normal fasting glucose (NFG), 61 subjects classed as impaired fasting glucose (IFG) according of the new fasting blood glucose (FBG) cut-off point of 100 mg/dL and 112 patients with diabetes mellitus (DM). All patients were evaluated for glucose, HbA1C, insulin, lipids, C-reactive protein (CRP) and homeostasis model assessment-insulin resistance. Pulse wave velocity (PWV) and augmentation index (AI) were performed as a noninvasive recording of the two artery sites pressure waveform using SphygmoCor (version 7.1, AtCor Medical, Sydney, Australia).
Pulse wave velocity, augmentation index and central arterial pressure increased consistently with deterioration of glucose tolerance. PWV was significantly higher in subjects with diabetes than in the normal and IFG groups (p < 0.0001 and p = 0.007, respectively). IFG subjects had marginally higher PWV than normal subjects (p = 0.050). Compared to normal subjects, IFG and diabetes groups were associated with increased AI (p = 0.003 and p < 0.0001, respectively). Arterial stiffness parameters remained significantly higher in both IFG and diabetes groups compared to normal after adjustment for cardiovascular risk factors and concomitant medications. Positive correlations between FBG, HbA1C and arterial stiffness parameters were detected.
Arterial stiffness parameters varied significantly across subgroups of patients with different degrees of impaired glucose regulation, such that increasingly deranged glucose homeostasis was associated with increased arterial stiffness. Early adverse vascular changes were detected in subjects with IFG.
葡萄糖耐量异常会导致动脉壁的结构和功能发生变化。本研究旨在探讨血糖调节受损（IGR）患者的葡萄糖耐量状态与动脉僵硬度之间的关系。
研究组共 284 例患者，包括 111 例空腹血糖正常（NFG）患者、61 例根据新的空腹血糖（FBG）100mg/dL 切点诊断为空腹血糖受损（IFG）的患者和 112 例糖尿病（DM）患者。所有患者均评估了血糖、糖化血红蛋白（HbA1C）、胰岛素、血脂、C 反应蛋白（CRP）和稳态模型评估-胰岛素抵抗。采用 SphygmoCor（版本 7.1，AtCor Medical，悉尼，澳大利亚）对脉搏波速度（PWV）和增强指数（AI）进行非侵入性记录。
随着葡萄糖耐量的恶化，脉搏波速度、增强指数和中心动脉压逐渐升高。与正常和 IFG 组相比，糖尿病患者的 PWV 显著升高（p<0.0001 和 p=0.007）。IFG 患者的 PWV 略高于正常患者（p=0.050）。与正常组相比，IFG 和糖尿病组的 AI 均显著升高（p=0.003 和 p<0.0001）。在校正心血管危险因素和伴随药物后，IFG 和糖尿病组的动脉僵硬度参数仍显著高于正常组。FBG、HbA1C 与动脉僵硬度参数呈正相关。
在不同程度的葡萄糖调节受损的患者亚组中，动脉僵硬度参数存在显著差异，血糖稳态越紊乱，动脉僵硬度越高。IFG 患者出现了早期的血管不良变化。
