Study on changes of vascular endothelium secreted factors after oral fatty meal test in elderly diabetic patients / 中华老年医学杂志

ABSTRACT

Objective To investigate the dynamic changes of vascular endothelium secreted factors after oral fatty meal test and the correlation of the factors with blood lipid in elderly diabetic patients. Methods Thirty-six elderly diabetic patients (diabetic group) and twenty heahhy elderly subjects(control group) were selected into the study and received oral fatty meal test for 6 hours. Diabetic group was divided into three subgroups, including fasting hypertriglyceridemia subgroup, postprandial hypertriglyceridemia subgroup and postprandial normotriglyceridemia subgroup. Serum nitric oxide (NO), endothelin-1 (ET-1), plasminogen activator inhibitor-1 (PAl-1) and tissue plasminogen activator (t-PA) were measured before and after oral fatty meal test. Results (1) The level of serum NO was significantly increased and ET-1 was significantly reduced in control group 2 hours after oral fatty meal test and were returned to basal state 6 hours after the test. But in diabetic group, postprandial serum NO level were decreased and ET-1 were increased gradually and reached to the peak 6 hours after oral fatty meal test. The ratio of NO/ET-1 was lower in diabetic group than that in control group (P< 0.01). There were important differences among fasting hypertriglyceridemia subgroup, postprandial hypertriglyceridemia subgroup and postprandial normotriglyeeridemia subgroup(P<0.05 or<0.01). (2) The level of PAl-1 was increased and t-PA was decreased slightly 4 hours after oral fatty meal test in control and diabetic groups. Compared with control group, PAI-1/ t-PA obviously increased in diabetic group. Meanwhile, PAI-1/t-PA in fasting hypertriglyeeridemia and postprandial hypertriglyceridemia subgroups were significantly higher than that in postprandial normotriglyceridemia subgroup(P<0. 05 or<0.01). (3) In the diabetic group, TG was negatively correlated with NO and t-PA(r=-0.360 P<0.05; r=-0.649, P<0.01) and positively correlated with ET-1 and PAI-1(r=0.421,P<0.01;r=0.520,P<0.01). Conclusions The elderly diabetic patients suffer from the imbalance of vascular endothelium secreted factors. The postprandial abnormal TG metabolism may aggravate the change and further damage the vascular endothelial function.