Endothelium-Dependent Vascular Relaxation in Patients With Type I Diabetes
Endothelium-Dependent Vascular Relaxation in Patients With Type I Diabetes
复制标题
I 型糖尿病患者的内皮依赖性血管舒张
作者：
P. Smits;J. Kapma;M. Jacobs;J. Lutterman;T. Then
内皮在调节血管张力中起着重要的作用。虽然动物数据显示糖尿病患者内皮依赖性血管舒张受损的证据，但人体体内数据很少。我们调查了11名1型糖尿病患者和11名匹配的健康对照者。选择代谢调节相对较差（HbA1c > 8.5%）但无微血管并发症迹象的糖尿病患者。在所有受试者中，我们记录了前臂对三种不同刺激的血管扩张反应：1)前臂缺血5分钟以获得最大血管扩张反应；2)臂动脉灌注MCh（剂量：0.03-0.3-1.0 μg·min - 1·100 ml - 1前臂体积）评价内皮依赖性血管舒张；3)动脉内灌注SNP（剂量：0.06-0.2-0.6 ng·min−1·100 ml−1）以评估内皮不依赖性血管舒张作用。糖尿病患者在试验开始前90分钟按常规皮下注射胰岛素并吃早餐。两组血压和FBF基线水平相似。两组的PORH反应相似，糖尿病患者的FVR百分比下降为92±1%，对照组为94±1%。在对照组中，MCh输注产生了剂量依赖性的血管扩张剂反应，FVR最大下降90±2%。最高剂量的SNP诱导FVR下降81±6%。在糖尿病患者中，与对照组相比，在不同剂量的MCh和SNP期间，FVR的下降百分比相似。我们得出结论，慢性高血糖，如发生在我们的无并发症的糖尿病患者，不损害内皮依赖性血管舒张在体内。
The endothelium plays an important role in the regulation of vascular tone. Although animal data show evidence for an impaired endothelium-dependent vasodilation in diabetes, human in vivo data are scarce. We investigated 11 type I diabetic patients and 11 matched healthy control subjects. The diabetic patients were selected on their relatively poor metabolic regulation (HbA1c > 8.5%), but none showed signs of microvascular complications. In all subjects, we recorded the forearm vasodilator responses to three different stimuli: 1) 5 min of forearm ischemia to obtain a maximal vasodilator response; 2) infusion of MCh into the brachial artery (dosages: 0.03–0.3–1.0 μg · min−1 · 100 ml−1 forearm volume) to evaluate endothelium-dependent vasodilation; and 3) intra-arterial infusion of SNP (dosages: 0.06–0.2–0.6 ng · min−1 · 100 ml−1) to evaluate endotheliumindependent vasodiiation. The diabetic patients had their usual subcutaneous insulin dose and breakfast 90 min before the start of the test. Baseline levels of BP and FBF were similar in both groups. The PORH response was similar in both groups, with a percentage fall in FVR of 92 ± 1% in diabetic patients and 94 ± 1% in control subjects. In the control subjects, MCh infusions exerted a dose-dependent vasodilator response with a maximal fall in the FVR of 90 ± 2%. The highest dose of SNP induced a fall in FVR of 81 ± 6% in this group. In diabetic patients, thepercentage decrements in FVR during the several dosages of MCh and SNP were similar when compared with the control group. We conclude that chronic hyperglycemia, as occurred in our patients with uncomplicated diabetes mellitus, does not impair endothelium-dependent vasodilation in vivo.
DOI：
10.1152/ajpheart.1989.257.5.h1327
发表时间：
1989-11
期刊：
The American journal of physiology
影响因子：
--
作者：
B. Tesfamariam;J. Jakubowski;Richard A. Cohen
通讯作者：
B. Tesfamariam;J. Jakubowski;Richard A. Cohen
影响因子：
158.5
作者：
DETEJADA, IS;GOLDSTEIN, I;COHEN, RA
通讯作者：
COHEN, RA
影响因子：
15.9
作者：
TESFAMARIAM, B;BROWN, ML;COHEN, RA
通讯作者：
COHEN, RA