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|本期目录/Table of Contents|

褪黑素对2型糖尿病患者血管内皮功能的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2013年第4期
页码:
414-417
栏目:
临床研究
出版日期:
2013-07-25

文章信息/Info

Title:
Effect of melatonin on function of vascular endothelium in patients with type 2 diabetes mellitus
作者:
李 岚1; 徐尔理1; 樊 民2; 张 征1; 钱萍萍3
(解放军411医院：1.分泌科，3.营养科，上海 200081；2.第二军医大学附属长征医院心内科，上海 200003)
Author(s):
LI Lan1;  XU Erli1;  FAN Min2;  ZHANG Zheng1;  QIAN Pingping3
(Department of Endocrinology, PLA 411 Hospital, Shanghai 200081, China)
关键词:
褪黑素; 2型糖尿病; 血管内皮; 内皮依赖性血管舒张
Keywords:
melatonin;  type 2 diabetes mellitus;  endothelial function;  endotheliumindependent nitroglycerinmediated vasodilation
分类号:
R587.1
DOI:
-
文献标识码:
A
摘要:
目的:探讨褪黑素对2型糖尿病患者血管内皮功能的影响。方法:选择早期无大血管并发症的2型糖尿病患者60例，随机分为试药组和对照组各30例，对照组采用饮食、运动、胰岛素治疗，试药组加用褪黑素（MLT）胶囊6 mg，每晚口服，共治疗6个月。同期选择28例健康个体为正常对照组。治疗前后检测血压、空腹血糖（FPG）、餐后2 h血糖（2hPG）、糖化血红蛋白（HbA1c）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C），计算体质量指数（BMI）。用高分辨率超声检测、计算肱动脉血流介导的内皮依赖性血管舒张功能(FMD)和硝酸甘油介导的内皮非依赖性血管舒张功能(NMD)。结果:①与正常对照组比较,糖尿病组治疗前FPG、2hPG、HbA1c、TG、LDL-C明显增高(均P<0.01)，HDL-C明显降低(P<0.05)。 治疗半年后糖尿病组TG、LDL-C略下降，BMI、HDLC略升高但均无统计学差异，FBG、2hPG、HbA1c无明显变化。②与正常对照组比较, 糖尿病组治疗前肱动脉基础内径、NMD无显著差异，FMD明显降低（均P<0.01）。治疗半年后糖尿病各组肱动脉基础内径、NMD无明显变化；FMD明显升高（P<0.05或P<0.01），试药组FMD明显高于对照组（P<0.05）。结论:2型糖尿病患者早期出现血管内皮舒张功能降低，褪黑素明显改善2型糖尿病早期患者受损血管内皮功能。
Abstract:
AIM:To investigate the protective effect of melatonin on functions of vascular endothelium in patients with type 2 diabetes mellitus (T2DM). METHODS: Sixty patients with T2DM without significant vascular complications were randomly divided into treatment group and control group and 28 healthy individuals were included as normal controls in the study. Patients in the control group were given conventional therapy including diabetic diet, regular aerobic exercise and insulin. On the basis of the conventional therapy, patients in the treatment group were given melatonin (MLT) (6 mg/day) at 21:00 h. All patients were treated for 6 months. Blood pressure, fasting plasma glucose (FPG), 2 h postprandial blood glucose (2hPPG), glycosylated hemoglobin (HbA1c), triglyceride (TG), lowdensity lipoprotein cholesterol (LDLC) and highdensity lipoprotein cholesterol (HDLC) were measured before and after the therapy. Body mass index (BMI) was also calculated. Endotheliumdependent flowmediated vasodilation (FMD) and endotheliumindependent nitroglycerinmediated vasodilation (NMD) of brachial arterial blood were measured with highresolution extravascular ultrasound technique before and after the therapy. RESULTS: FPG, 2hPPG, HbA1c, TG, and LDLC were higher (P<001) and HDLC in diabetic groups were lower (P<005) than those in normal control group before treatment. After the 6month treatment, TG and LDLC decreased, BMI and LDLC increased but without significant difference in the above statistics. FBG, 2hPPG and HbA1c showed no change. Before treatment, no significant difference in the baseline vessel size and NMD was found between diabetic groups and normal control group but FMD decreased significantly (P<001). After the 6month treatment, no significant changes were found in baseline vessel size and NMD in diabetic groups compared with those before treatment. FMD in patients of the treatment group and control group increased significantly after treatment (P<005 or P<001). FMD in patients of the treatment group was significantly higher than in the control group (P<005). CONCLUSION: FMD is impaired in patients with T2DM without significant vascular complications. MLT can markedly improve vascular endothelial functions in patients with T2DM.

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备注/Memo

备注/Memo:
收稿日期：2013-01-08.基金项目：上海市虹口区科研基金项目资助（090308） 通讯作者：樊民，副主任医师，主要从事炎症与动脉粥样硬化研究 Email：fanmin@medmail.com.cn 作者简介：李岚，主治医师，硕士 Email：lilan411@126.com
更新日期/Last Update: 2013-07-29