Endocrinology and Diabetes Unit, Hospital Clínic I Universitari, Bareclona, Spain.
Diab Vasc Dis Res. 2011 Jan;8(1):5-11. doi: 10.1177/1479164110388674. Epub 2010 Nov 25.
We aimed to investigate preclinical atherosclerosis in T1D and its relationship with glucose profile and endothelial/ inflammatory markers. Thirty-eight T1D patients without additional cardiovascular risk factors or micro-/macrovascular complications and 22 healthy matched subjects were included. FMD and cIMT/fIMT were performed in addition to 72-h continuous glucose monitoring and the measurement of endothelial/inflammatory markers. Lower FMD percentages and greater cIMT/fIMT were observed in patients with T1D in comparison with controls (FMD 7.0 ± 3.1% vs. 9.6 ± 2.2%; p<0.005; cIMT 0.523 ± 0.091 mm vs. 0.471 ± 0.061 mm; p<0.05 and fIMT 0.512 ± 0.172 mm vs. 0.394 ± 0.061 mm; p<0.01, for patients and controls, respectively). T1D subjects in the highest tertile of cIMT were older than those in the lowest group (39.9 ± 9.5 vs. 29.6 ± 4.7 years; p<0.005) and had a longer duration of the disease (18.7 ± 5.4 years vs. 11.8 ± 6.4 years). The higher the cIMT tertile, the greater the fIMT (0.397 ± 0.114 mm vs. 0.431 ± 0.082 mm vs. 0.583 ± 0.197 mm; p<0.05). MAGE was negatively correlated to FMD (r=-0.328; p<0.05) and positively to cIMT (r=0.322; p<0.05). There were no differences between cIMT tertiles in terms of metabolic parameters or endothelial and inflammatory markers. Signals of preclinical atherosclerosis in T1D even in the absence of cardiovascular risk factors and micro- / macrovascular disease are reported. Our findings suggest that daily glucose instability could negatively impact vascular function and structure.
我们旨在研究 T1D 患者的临床前动脉粥样硬化及其与血糖谱和内皮/炎症标志物的关系。纳入 38 例无其他心血管危险因素或微血管/大血管并发症的 T1D 患者和 22 例健康匹配的对照。除了 72 小时连续血糖监测和内皮/炎症标志物测量外，还进行了 FMD 和 cIMT/fIMT。与对照组相比，T1D 患者的 FMD 百分比较低，cIMT/fIMT 较大（FMD 7.0 ± 3.1% vs. 9.6 ± 2.2%；p<0.005；cIMT 0.523 ± 0.091 mm vs. 0.471 ± 0.061 mm；p<0.05 和 fIMT 0.512 ± 0.172 mm vs. 0.394 ± 0.061 mm；p<0.01，分别为患者和对照组）。cIMT 最高三分位的 T1D 患者比最低三分位的患者年龄更大（39.9 ± 9.5 岁 vs. 29.6 ± 4.7 岁；p<0.005），且疾病持续时间更长（18.7 ± 5.4 年 vs. 11.8 ± 6.4 年）。cIMT 三分位越高，fIMT 越大（0.397 ± 0.114 mm vs. 0.431 ± 0.082 mm vs. 0.583 ± 0.197 mm；p<0.05）。MAGE 与 FMD 呈负相关（r=-0.328；p<0.05），与 cIMT 呈正相关（r=0.322；p<0.05）。在代谢参数或内皮和炎症标志物方面，cIMT 三分位之间没有差异。即使在没有心血管危险因素和微血管/大血管疾病的情况下，T1D 也存在临床前动脉粥样硬化的迹象。我们的研究结果表明，血糖的日常不稳定性可能会对血管功能和结构产生负面影响。
