Allen Jason D, Stabler Thomas, Kenjale Aarti A, Ham Katherine L, Robbins Jennifer L, Duscha Brian D, Kraus William E, Annex Brian H
Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA; Department of Medicine, Duke University Medical Center, Durham, NC, USA.
Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA.
J Diabetes Complications. 2014 Mar-Apr;28(2):219-25. doi: 10.1016/j.jdiacomp.2013.08.002. Epub 2013 Dec 17.
To determine if type 2 diabetes mellitus (T2D) differentiates endothelial function and plasma nitrite response (a marker of nitric oxide bioavailability) during exercise in peripheral arterial disease (PAD) subjects prior to and following 3 months supervised exercise training (SET).
In subjects with T2D+PAD (n = 13) and PAD-only (n = 14), endothelial function was measured using brachial artery flow-mediated dilation. On a separate day, venous blood draws were performed at rest and 10 min following a symptom-limited graded treadmill test (SL-GXT). Plasma samples were snap-frozen for analysis of nitrite by reductive chemiluminescence. All testing was repeated following 3 months of SET.
Prior to training both groups demonstrated endothelial dysfunction, which was correlated with a net decrease in plasma nitrite following a SL-GXT (p ≤ 0.05). Following SET, the PAD-only group demonstrated an improvement in endothelial function (p ≤ 0.05) and COT (p ≤ 0.05), which was related to a net increase in plasma nitrite following the SL-GXT (both p ≤ 0.05). The T2D+PAD group had none of these increases.
T2D in the presence of PAD attenuated improvements in endothelial function, net plasma nitrite, and COT following SET. This suggests that T2D maybe associated with an inability to endogenously increase vascular NO bioavailability to SET.
确定2型糖尿病（T2D）是否会在3个月的监督运动训练（SET）前后，使外周动脉疾病（PAD）患者运动期间的内皮功能和血浆亚硝酸盐反应（一氧化氮生物利用度的标志物）产生差异。
在患有T2D+PAD的受试者（n = 13）和仅患有PAD的受试者（n = 14）中，使用肱动脉血流介导的血管舒张来测量内皮功能。在另一天，在静息状态下以及症状限制级平板运动试验（SL-GXT）后10分钟采集静脉血。血浆样本速冻后通过还原化学发光法分析亚硝酸盐。在3个月的SET后重复所有测试。
训练前两组均表现出内皮功能障碍，这与SL-GXT后血浆亚硝酸盐的净减少相关（p≤0.05）。SET后，仅患有PAD的组内皮功能（p≤0.05）和COT（p≤0.05）有所改善，这与SL-GXT后血浆亚硝酸盐的净增加有关（两者p≤0.05）。T2D+PAD组没有这些增加。
存在PAD的T2D会减弱SET后内皮功能、血浆亚硝酸盐净含量和COT的改善。这表明T2D可能与内源性增加血管一氧化氮生物利用度以适应SET的能力不足有关。
