Walther Guillaume, Obert Philippe, Dutheil Frédéric, Chapier Robert, Lesourd Bruno, Naughton Geraldine, Courteix Daniel, Vinet Agnès
From the Avignon University, LAPEC EA4278, Avignon, France (G.W., P.O., A.V.); Blaise Pascal University, Laboratory Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), Clermont-Ferrand, France (F.D., B.L., D.C.); University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France (F.D., B.L.); Omental-Thermalia Center, Châtelguyon, France (R.C.); and School of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia (P.O., F.D., G.N., D.C.).
Arterioscler Thromb Vasc Biol. 2015 Apr;35(4):1022-9. doi: 10.1161/ATVBAHA.114.304591. Epub 2015 Feb 5.
The first objective of this study was to demonstrate differences within endothelial-dependent and endothelial-independent vasoreactivity in macro- and microcirculation beds among patients with metabolic syndrome (MetS) with and without type 2 diabetes mellitus (T2D) compared with healthy counterparts. The second objective was to determine relationships among the function of macro- and microvascular systems and abdominal adiposity, as well as inflammatory markers in the 3 groups.
Cross-sectional analyses of 53 patients with MetS without T2D and 25 with T2D, as well as aged 40 years and sex-matched healthy controls included microvascular (cutaneous blood flow measured with laser Doppler flowmetry in response to iontophoresis of acetylcholine and sodium nitroprusside), and macrovascular reactivity (flow-mediated dilation and nitrate-mediated dilation) along with anthropometric measures, plasma glucose, and insulin and inflammatory markers. Compared with controls, MetS participants showed depressed endothelial function of both micro- and macrocirculation beds. T2D in patients with MetS revealed an exacerbated vascular smooth muscle dysfunction in micro- and macrocirculation compared with MetS without T2D. Indices of micro- and macrocirculation were predominantly inversely related to abdominal fat and inflammatory markers.
MetS was associated with endothelial-dependent and endothelial-independent dysfunction, affecting both the macro- and the microvascular systems. Participants with diabetes mellitus demonstrated the most severe smooth muscle dysfunction. The presence of central abdominal fat and systemic inflammation seems implicated in the pathogenesis of vascular dysfunctions in MetS.
本研究的首要目的是，与健康对照者相比，证明伴有和不伴有2型糖尿病（T2D）的代谢综合征（MetS）患者在大循环和微循环床中内皮依赖性和非内皮依赖性血管反应性的差异。第二个目的是确定三组中微血管和大血管系统功能与腹部肥胖以及炎症标志物之间的关系。
对53例无T2D的MetS患者、25例有T2D的患者以及年龄40岁且性别匹配的健康对照者进行横断面分析，包括微血管（用激光多普勒血流仪测量皮肤血流，以响应乙酰胆碱和硝普钠的离子导入）和大血管反应性（血流介导的扩张和硝酸盐介导的扩张），以及人体测量指标、血浆葡萄糖、胰岛素和炎症标志物。与对照组相比，MetS参与者的微循环和大循环床的内皮功能均降低。与无T2D的MetS患者相比，有T2D的MetS患者在微循环和大循环中显示出血管平滑肌功能障碍加剧。微循环和大循环指标主要与腹部脂肪和炎症标志物呈负相关。
MetS与内皮依赖性和非内皮依赖性功能障碍相关，影响大血管和微血管系统。糖尿病患者表现出最严重的平滑肌功能障碍。腹部中央脂肪和全身炎症的存在似乎与MetS血管功能障碍的发病机制有关。
