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2型糖尿病合并高尿酸血症的正常血糖一级亲属的内皮功能障碍

Endothelial dysfunction in normoglycaemic first-degree relatives of type 2 diabetes mellitus complicated with hyperuricaemia.

作者信息

Zhang Junxia, Xiang Lin, Zhang Bilin, Cheng Yangyang

机构信息

Department of Endocrinology, Wuhan General Hospital of Guangzhou Command, Wuhan, China.

出版信息

Diab Vasc Dis Res. 2017 Mar;14(2):88-93. doi: 10.1177/1479164116678158. Epub 2016 Dec 21.

Abstract

OBJECTIVE

To reveal the effect of hyperuricaemia on endothelial function in normoglycaemic first-degree relatives of type 2 diabetes mellitus.

METHODS

In all, 40 first-degree relatives of type 2 diabetes mellitus with hyperuricaemia, 40 first-degree relatives of type 2 diabetes mellitus with normouricaemia and 35 healthy subjects without diabetic family history were recruited in this study. Anthropometric parameters as well as blood pressure, blood lipids, fasting blood glucose, fasting insulin, C-reactive protein, tumour necrosis factor-α and interleukin-6 were measured. Insulin resistance was assessed with homoeostasis model assessment index-insulin resistance index. To assess endothelial function, high-resolution ultrasonography was used for measuring flow- and nitroglycerine-mediated brachial artery vasodilation.

RESULTS

When compared with control, flow-mediated dilation was lower in first-degree relatives with or without hyperuricaemia (both p < 0.001). When compared with first-degree relative subjects with normouricaemia, there were lower flow-mediated dilation ( p < 0.001) and higher levels of uric acid ( p < 0.001), fasting blood glucose ( p < 0.001), C-reactive protein ( p = 0.001), tumour necrosis factor-α ( p < 0.001) and interleukin-6 ( p < 0.001) in first-degree relative subjects with hyperuricaemia. Flow-mediated dilation was found to be negatively related to uric acid ( r = -0.597, p < 0.001). Stepwise multiple regressions demonstrated that uric acid was a significant determinant of flow-mediated dilation independent of other variables in first-degree relatives of type 2 diabetes mellitus (β = -0.677, p < 0.001; confidence interval: -0.010 to -0.006).

CONCLUSION

Further endothelial dysfunction is found in normoglycaemic first-degree relatives of type 2 diabetes mellitus complicated with hyperuricaemia.

摘要

目的

揭示高尿酸血症对2型糖尿病正常血糖一级亲属内皮功能的影响。

方法

本研究共纳入40例伴有高尿酸血症的2型糖尿病一级亲属、40例尿酸正常的2型糖尿病一级亲属以及35例无糖尿病家族史的健康受试者。测量人体测量参数以及血压、血脂、空腹血糖、空腹胰岛素、C反应蛋白、肿瘤坏死因子-α和白细胞介素-6。采用稳态模型评估指数-胰岛素抵抗指数评估胰岛素抵抗。为评估内皮功能,使用高分辨率超声测量血流介导的肱动脉扩张和硝酸甘油介导的肱动脉扩张。

结果

与对照组相比,伴有或不伴有高尿酸血症的一级亲属的血流介导的扩张均较低(均p < 0.001)。与尿酸正常的一级亲属受试者相比,高尿酸血症的一级亲属受试者的血流介导的扩张较低(p < 0.001),尿酸、空腹血糖、C反应蛋白、肿瘤坏死因子-α和白细胞介素-6水平较高(均p < 0.001)。发现血流介导的扩张与尿酸呈负相关(r = -0.597,p < 0.001)。逐步多元回归表明,在2型糖尿病一级亲属中,尿酸是独立于其他变量的血流介导的扩张的重要决定因素(β = -0.677,p < 0.001;置信区间:-0.010至-0.006)。

结论

在合并高尿酸血症的2型糖尿病正常血糖一级亲属中发现进一步的内皮功能障碍。

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