摘要
目的探讨内皮功能障碍与胰岛素抵抗(IR)的因果关系。方法260例无代谢性疾病和心血管病的中年肥胖患者,其中内皮功能异常者157例,内皮功能正常者103例,均随机分为减重干预组和未干预组。另选87例正常体重的健康人作为正常对照组。强化生化方式减重干预2年,随访前后测定体脂、血压、血脂、空腹血糖和胰岛素,计算IR指数(HOMAIR),并通过高分辨率超声评价血管内皮功能。结果肥胖伴内皮功能异常者减重干预后内皮功能明显改善(4.56±4.79vs15.17±5.80,P<0.01),IR减轻(0.91±0.18vs0.68±0.22,P<0.01),未减重者内皮功能无改善,IR加重(0.92±0.20vs1.13±0.25,P<0.05);肥胖伴内皮功能正常者减重干预后内皮功能及胰岛素敏感性维持不变,而未减重者内皮功能出现异常(16.29±4.59vs7.88±5.24,P<0.01),胰岛素敏感性降低(0.66±0.30vs0.81±0.25,P<0.01)。结论内皮功能障碍是导致和加重肥胖者IR的重要原因,减重干预可逆转异常的内皮功能。
Objective To explore the relationship between endothelial dysfunction and insulin resistance （IR） during reduction of body weight in obese subjects. Methods 260 obese subjects without metabolic dimmers, cardiovascular disease and other clinically detectable diseases were enrolled in this study. Among them 157 patients were found to have impaired endothelial function and loa with normal endothelial function. They were randomly divided into body weight reduction intervention group and nonintervention group. The measures of intervention included food restriction, exercise, and drugs for weight reduction, and they were continued for two years. 87 subjects with normal weight and without endothdial dysfunction served as normal control. IR index （HOMA IR） and flow-mediated endothelium-dependent dilatation function were measured before and after the study period. Results After two years, it was found that the endothelial function was markedly improved （4. 56±4. 79 vs 15. 17±5. 80, P〈0. 01）, and IR was reduced （0. 91±0. 18 vs 0. 68±0. 22, P〈0. 01） in those with endothelial dysfunction in the intervention group, but the endothelial function was not improved and IR was aggravated （0. 92± 0. 20 vs 1. 20 ± 0.25, P〈0. 05） in nonintervention group. In individuals without endothelial dysfunction, the endothelial function and insulin sensitivity maintained constant in the intervention group, and endothelial dysfunction was detected （16. 29±4. 59 vs 7. 88±5. 24, P〈 0. 01） and insulin sensitivity was reduced （0. 66±0. 30 vs 0. 81±0. 25, P〈0. 01） in nonintervention group. Conclusion Endothelial dysfunction is an important cause of IR. Weight reduction can reverse impaired endothelial function.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2006年第1期71-73,共3页
Medical Journal of Chinese People's Liberation Army
关键词
内皮
血管
肥胖症
胰岛素抗药性
endothelium,vascular
obesityl insulin resistance
