血管内皮功能作为 2 型糖尿病无相关并发症患者肺功能变化的有效预测因子。
Vascular Endothelial Function as a Valid Predictor of Variations in Pulmonary Function in T2DM Patients Without Related Complications.
机构信息
Key Laboratory of Ministry of Education for Traditional Chinese Medicine Visera-State Theory and Application, Liaoning University of Traditional Chinese Medicine, Shenyang, China.
Department of Endocrinology and Metabolic, Liaoning Provincial Corps Hospital of Chinese People's Armed Police Forces, Shenyang, China.
出版信息
Front Endocrinol (Lausanne). 2021 Mar 11;12:622768. doi: 10.3389/fendo.2021.622768. eCollection 2021.
UNLABELLED
To assess the variations in pulmonary function and vascular endothelial function in their early stages (without related complications). A total of 162 type 2 diabetes mellitus (T2DM) patients without diabetes complications and 55 healthy people were selected, comprising the T2DM group and the control group, respectively, to evaluate changes in vascular endothelial function and lung function and determine the correlation between them. In this study, the T2DM group exhibited significantly lower pulmonary function than that of the control group ( < 0.05). The T2DM group also showed significantly lower flow-mediated dilation (FMD) and nitric oxide (NO) ( < 0.05) than those of the control group. Pulmonary functional indexes correlated positively with FMD and NO ( < 0.05) and correlated negatively with endothelin-1 (ET-1) ( < 0.05). FMD and NO correlated negatively with diabetes duration/HbA1c ( < 0.05), whereas ET-1 correlated positively with glycosylated hemoglobinA1c (HbA1c)/diabetes duration ( < 0.05). Pulmonary functional indexes negatively correlated with HbA1c/diabetes duration ( < 0.05). Multiple linear regression was used to analyze the relationship between vascular endothelial function indexes (FMD, ET-1, and NO) and pulmonary functional indexes. The results indicated that each vascular endothelial function index (FMD, ET-1, and NO) was significantly correlated with the pulmonary functional index ( < 0.05). The patients with T2DM presented changes in the subclinical vascular endothelial and pulmonary function. They also had impaired vascular endothelial functions, which were characterized by reduced vascular endothelial function relative to those of healthy people. Regulating glycemia may improve vascular endothelial and pulmonary functions. Moreover, microvascular lesions in preclinical stages, vascular endothelial function indexes (FMD, ET-1, and NO) were valid predictors of alterations in pulmonary function in T2DM patients without related complications.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov, identifier NCT03575988.
目的
评估 2 型糖尿病（T2DM）患者早期（无相关并发症）肺功能和血管内皮功能的变化。
方法
选取无糖尿病并发症的 162 例 T2DM 患者和 55 名健康人，分别为 T2DM 组和对照组，评估血管内皮功能和肺功能的变化，并确定它们之间的相关性。
结果
T2DM 组的肺功能明显低于对照组（<0.05）。T2DM 组的血流介导扩张（FMD）和一氧化氮（NO）明显低于对照组（<0.05）。肺功能指标与 FMD 和 NO 呈正相关（<0.05），与内皮素-1（ET-1）呈负相关（<0.05）。FMD 和 NO 与糖尿病病程/HbA1c 呈负相关（<0.05），而 ET-1 与糖化血红蛋白 A1c（HbA1c）/糖尿病病程呈正相关（<0.05）。肺功能指标与 HbA1c/糖尿病病程呈负相关（<0.05）。多元线性回归分析血管内皮功能指标（FMD、ET-1 和 NO）与肺功能指标的关系，结果表明各血管内皮功能指标（FMD、ET-1 和 NO）与肺功能指标均呈显著相关（<0.05）。
结论
T2DM 患者存在亚临床血管内皮和肺功能变化，表现为血管内皮功能受损，血管内皮功能低于健康人群。调节血糖可能改善血管内皮和肺功能。此外，在无相关并发症的 T2DM 患者中，微血管病变早期、血管内皮功能指标（FMD、ET-1 和 NO）是肺功能改变的有效预测指标。
临床试验注册号
ClinicalTrials.gov，标识符 NCT03575988。
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