The changes of vascular endothelial function and VEGF in patients with different disorders of glucose metabolism / 中国医师杂志

ABSTRACT

Objective To observe the changes of the endothelium-dependent vasodilatation(EDF)and serum vascular endothelial growth factor(VEGF)in the patients with impaired glucose tolerance(IGT)and type 2 diabetes mellitus(DM).Methods 30 IGT patients,30 type 2 DM patients and 33 normal subjects were divided into3 groups. Fasting glucose(FPG),fasting insulin(FINS),serum superoxide dismutase(SOD),maleie. dialdehyde(MDA)and VEGF were measured after 12 hours overnight fast. Oral 75g glucose tolerance test(OGTT)was performed. The inner diameter of braehial artery was assessed by a high resolution ultrasound system before and after reactive hyperemia. EDF was calculated as the percent change in brachial artery diameter 1 minute after reactive hyperemia compared with baseline. Results In the IGT group and DM group, EDF was significantly lower than that in NGT group(both P＜0.01),and EDF in the DM group was significantly lower than that in the IGT group(P＜0.01).SOD in the IGT group and DM group were significantly lower than that in the NGT group(both P＜0.01),but MDA in reverse(both P＜0.01).Compared with the IGT group, SOD in DM group was significantly lower(P＜0.01),but MDA was significantly higher(P＜0.01).VEGF was progressively increased in the NGT,IGT, DM groups. The difference between the two groups was significant(both P＜0.01).Stepwise regression analysis showed that EDF was positively related to SOD(r=0.418,P＜0.01,n=93),and negatively related to HOMA-IR and VEGF(r=-0.553,-0.221,both P＜0.01,n=93).VEGF was negatively related to SOD(r=-0.552,P＜0.01,n=93).Conclusion EDF is impaired in IGT patients while the impairment in DM patients becomes more marked. Insulin resistance, VEGF,SOD and MDA are closely related to the impairment of EDF in IGT and type 2 DM.