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1,5-脱水-D-葡萄糖醇水平低与2型糖尿病患者的血管内皮功能障碍有关。

Low levels of 1,5-anhydro-D-glucitol are associated with vascular endothelial dysfunction in type 2 diabetes.

作者信息

Torimoto Keiichi, Okada Yosuke, Mori Hiroko, Tanaka Yoshiya

机构信息

First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushyu-shi 807-8555, Japan.

出版信息

Cardiovasc Diabetol. 2014 Jun 13;13:99. doi: 10.1186/1475-2840-13-99.

Abstract

BACKGROUND

Vascular endothelial dysfunction is involved in macrovascular disease progression in type 2 diabetes mellitus (T2DM). We reported previously that blood glucose fluctuations, as evaluated by continuous glucose monitoring (CGM), correlate with vascular endothelial function, serving as a marker of vascular endothelial function. However, the use of CGM is limited, suggesting the need for another marker of vascular endothelial function. Here, we investigated the relationship between vascular endothelial dysfunction and blood levels of 1,5-anhydro-D-glucitol (1,5-AG), a marker of both postprandial hyperglycemia and fluctuations in blood glucose.

METHODS

In 32 inpatients with T2DM and HbA1c less than 8.0%, the reactive hyperemia index (RHI), an index of vascular endothelial function, was determined by peripheral arterial tonometry. The relationships between RHI and 1,5-AG, blood glucose, lipid metabolism markers, and blood pressure, were examined.

RESULTS

There was a strong correlation between 1,5-AG and natural logarithmic-scaled RHI (L_RHI) (r = 0.55; P = 0.001). However, there was no correlation between L_RHI and HbA1c, fasting blood glucose, IRI, LDL-C, HDL-C, TG, systolic blood pressure, or diastolic blood pressure. Multivariate analysis identified blood 1,5-AG levels to be the only significant and independent determinant of L_RHI.

CONCLUSIONS

In T2DM with HbA1c <8.0%, low 1,5-AG levels were associated with vascular endothelial dysfunction, suggesting it is a potentially useful marker for vascular endothelial dysfunction.

TRIAL REGISTRATION

UMIN000015317.

摘要

背景

血管内皮功能障碍参与2型糖尿病(T2DM)大血管疾病的进展。我们之前报道过,通过连续血糖监测(CGM)评估的血糖波动与血管内皮功能相关,可作为血管内皮功能的一个标志物。然而,CGM的应用存在局限性,这表明需要另一种血管内皮功能标志物。在此,我们研究了血管内皮功能障碍与1,5-脱水-D-葡萄糖醇(1,5-AG)血水平之间的关系,1,5-AG是餐后高血糖和血糖波动的一个标志物。

方法

在32例糖化血红蛋白(HbA1c)低于8.0%的T2DM住院患者中,通过外周动脉张力测定法测定血管内皮功能指标反应性充血指数(RHI)。研究了RHI与1,5-AG、血糖、脂质代谢标志物和血压之间的关系。

结果

1,5-AG与自然对数标度的RHI(L_RHI)之间存在强相关性(r = 0.55;P = 0.001)。然而,L_RHI与HbA1c、空腹血糖、胰岛素抵抗指数(IRI)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、收缩压或舒张压之间无相关性。多变量分析确定血1,5-AG水平是L_RHI唯一显著且独立的决定因素。

结论

在HbA1c <8.0%的T2DM患者中,低1,5-AG水平与血管内皮功能障碍相关,提示它可能是血管内皮功能障碍的一个有用标志物。

试验注册

UMIN000015317。

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