INHIBITION AND STIMULATION OF NITRIC-OXIDE SYNTHESIS IN THE HUMAN FOREARM ARTERIAL BED OF PATIENTS WITH INSULIN-DEPENDENT DIABETES
INHIBITION AND STIMULATION OF NITRIC-OXIDE SYNTHESIS IN THE HUMAN FOREARM ARTERIAL BED OF PATIENTS WITH INSULIN-DEPENDENT DIABETES
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DOI：
10.1172/jci116149
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发表时间：
1992-12-01
影响因子：
15.9
通讯作者：
VALLANCE, P
中科院分区：
文献类型：
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作者：
CALVER, A;COLLIER, J;VALLANCE, P
胰岛素依赖型糖尿病患者由于血管并发症而具有增加的死亡率和发病率。来自血管内皮的一氧化氮有助于正常血管张力的控制，并且内皮功能障碍已被牵连在糖尿病血管疾病的发病机制中。在这项研究中，我们研究了基础和刺激一氧化氮介导的血管舒张胰岛素依赖型糖尿病患者和年龄和性别匹配的健康对照。将药物局部注入肱动脉，并使用静脉闭塞体积描记法测量前臂血流。去甲肾上腺素和N（G）-单甲基-L-精氨酸在健康对照组的静息前臂血流量中产生类似的减少。然而，在糖尿病患者中，N（G）-单甲基-L-精氨酸的效果明显低于去甲肾上腺素。组间比较，糖尿病患者对N（G）-单甲基-L-精氨酸的反应也明显低于健康对照组。与健康对照组相比，糖尿病患者对硝普钠的反应显著降低，而对乙酰胆碱和维拉帕米的反应在两组中相同。结果提供了证据的基础一氧化氮介导的扩张在前臂动脉床的胰岛素依赖型糖尿病患者的异常，并表明，血管平滑肌是不敏感的一氧化氮。
Patients with insulin-dependent diabetes mellitus have an increased mortality and morbidity due to vascular complications. Nitric oxide from the vascular endothelium contributes to the control of normal vascular tone, and endothelial dysfunction has been implicated in the pathogenesis of diabetic vascular disease. In this study we have examined basal and stimulated nitric oxide-mediated vasodilatation in insulin-dependent diabetics and age- and sex-matched healthy controls. Drugs were infused locally into the brachial artery and forearm blood flow measured using venous occlusion plethysmography. Noradrenaline and N(G)-monomethyl-L-arginine produced similar reductions in resting forearm blood flow in healthy controls. However, in the diabetics, N(G)-monomethyl-L-arginine was significantly less effective than noradrenaline. Comparing between groups, the response to N(G)-monomethyl-L-arginine was also significantly less in the diabetics compared with the healthy controls. The response to sodium nitroprusside was significantly less in the diabetics compared with the healthy controls, whereas the responses to both acetylcholine and verapamil were the same in the two groups. The results provide evidence for an abnormality of basal nitric oxide-mediated dilatation in the forearm arterial bed of patients with insulin-dependent diabetes mellitus, and suggest that the vascular smooth muscle is less sensitive to nitric oxide.