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糖尿病患者一级亲属中空腹甘油三酯反应与内皮功能的关系。

Postprandial triglyceride responses and endothelial function in prediabetic first-degree relatives of patients with diabetes.

机构信息

Department of Endocrinology, Centre for Diabetes Endocrinology & Metabolism, University College of Medical Sciences & GTB Hospital, Delhi, India.

Department of Endocrinology, Centre for Diabetes Endocrinology & Metabolism, University College of Medical Sciences & GTB Hospital, Delhi, India; Department of Medicine, University College of Medical Sciences & GTB Hospital, Delhi, India.

出版信息

J Clin Lipidol. 2017 Nov-Dec;11(6):1415-1420. doi: 10.1016/j.jacl.2017.08.001. Epub 2017 Aug 8.

Abstract

BACKGROUND

Only a few studies have reported on postprandial lipid responses and endothelial function in prediabetic subjects. None of the study has compared role of familial predisposition in determining postprandial endothelial dysfunction and postprandial hypertriglyceridemia in subjects with prediabetes.

OBJECTIVE

The objective was to study the postprandial triglyceride (PPTG) responses and endothelial function in prediabetic first-degree relatives of patients with diabetes.

METHODS

Thirty-nine subjects were recruited on the basis of oral glucose tolerance test into 3 groups: group 1, prediabetic subjects who had a first-degree relative with diabetes; group 2, prediabetic subjects without family history of diabetes; and group 3, normal glucose tolerance subjects without family history of diabetes. Oral fat challenge test was performed in all study subjects and PPTG responses were measured up to 8 hours. Postprandial endothelial function after 4 hours of fat challenge was estimated by flow-mediated dilation.

RESULTS

Postprandial endothelial dysfunction was greatest in group 1 and significantly higher in group 1 compared with group 2 (P < .001) and group 2 compared with group 3 (P < .001). PPTG responses (TG-AUC, TG-peak, TG-6 hour, and TG-8 hour) were significantly higher in group 1 compared with groups 2 and 3. However, they were similar between groups 2 and 3. Endothelial function showed significant negative correlation with TG-6 hour and TG-8 hour.

CONCLUSION

Prediabetic subjects respond to fat challenge with a greater degree of TG response and endothelial dysfunction compared with normal glucose tolerance subjects especially if they have a first-degree relative with diabetes. This may contribute to enhanced cardiovascular risk reported in prediabetic individuals.

摘要

背景

仅有少数研究报告了糖尿病前期患者的餐后血脂反应和内皮功能。没有一项研究比较过家族易感性在决定糖尿病前期患者餐后内皮功能障碍和餐后高甘油三酯血症中的作用。

目的

本研究旨在研究糖尿病患者一级亲属的糖尿病前期患者的餐后甘油三酯(PPTG)反应和内皮功能。

方法

根据口服葡萄糖耐量试验,将 39 名受试者纳入 3 组:组 1,有糖尿病一级亲属的糖尿病前期患者;组 2,无家族糖尿病史的糖尿病前期患者;组 3,无家族糖尿病史的正常糖耐量受试者。所有研究对象均进行口服脂肪负荷试验,并测量 8 小时内的 PPTG 反应。在脂肪负荷 4 小时后,通过血流介导的扩张来评估餐后内皮功能。

结果

组 1 的餐后内皮功能障碍最大,且明显高于组 2(P<0.001)和组 2 高于组 3(P<0.001)。组 1 的 PPTG 反应(TG-AUC、TG-peak、TG-6 小时和 TG-8 小时)明显高于组 2 和组 3。然而,组 2 和组 3 之间的 PPTG 反应相似。内皮功能与 TG-6 小时和 TG-8 小时呈显著负相关。

结论

与正常糖耐量受试者相比,糖尿病前期患者对脂肪负荷的反应更大程度地表现出 TG 反应和内皮功能障碍,尤其是如果他们有一级亲属患有糖尿病。这可能导致糖尿病前期患者报告的心血管风险增加。

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