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JCEM:生活方式干预对代谢综合征患者血管胰岛素抵抗的影响(Resolve研究)

2014-10-31 MedSci MedSci原创

对代谢综合征来说,依赖胰岛素的血管舒张功能受损可能导致患者微血管功能障碍。这项研究旨在评估胰岛素在代谢综合征中的血管活性作用,并且评价生活方式干预的作用。 研究设计: 研究对38名代谢综合征患者和18名对照者采用激光多普勒评价皮肤血流(CBF),并通过电离渗透法将胰岛素或乙酰胆碱导入皮肤,继而监测皮肤内血流动力学的变化情况。同时还测定了人体测量指标、血浆胰岛素、血糖及炎症水平等多项指标

对代谢综合征来说,依赖胰岛素的血管舒张功能受损可能导致患者微血管功能障碍。这项研究旨在评估胰岛素在代谢综合征中的血管活性作用,并且评价生活方式干预的作用。

研究设计:

研究对38名代谢综合征患者和18名对照者采用激光多普勒评价皮肤血流(CBF),并通过电离渗透法将胰岛素或乙酰胆碱导入皮肤,继而监测皮肤内血流动力学的变化情况。同时还测定了人体测量指标、血浆胰岛素、血糖及炎症水平等多项指标。其中有24名代谢综合征患者进行了为期6个月的生活方式干预(M6),以及3周的后续项目(D21)。

研究结果:

胰岛素和乙酰胆碱作用后CBF的绝对和相对高峰在对照组明显高于代谢综合征组。胰岛素刺激的皮肤血流高峰与血糖、HbA1c、纤溶酶原激活物抑制剂1PAI-1)、C反应蛋白(CRP)和IL-6等指标存在显著负相关关系。在血流动力学方面,代谢综合征患者的总光谱CBF及其所有组分(除了一个与呼吸相关的)数值偏低。而经过D21M6后,胰岛素刺激CBF峰值有所增加,并且与对照组相比不再有差异,而乙酰胆碱刺激CBF峰值没有发生变化。从D21项目看,代谢综合征组的总CBF光谱及各组分的数值与对照组接近。基线水平及M6期间胰岛素刺激CBF峰值及内皮成分的变化与CRPPAI-1存在负相关关系。

研究结论:

代谢综合征患者表现出局部胰岛素血管舒张作用以及总体血流动力学受损,并且证实与炎症有关。通过生活方式干预炎症水平的下降,同时这种胰岛素介导的血管功能障碍能够获得逆转。

原始出处:

Agnes VinetPhD, Philippe ObertPhD , Frederic DutheilMD, PhD , Lamine DiagneMSc, Robert ChapierMD, Bruno LesourdMD, PhD, Daniel CourteixPhD, and Guillaume WaltherPhD. Impact of a lifestyle program on vascular insulin resistance in metabolic syndrome subjects: the Resolve study. JCEM, October 29, 2014.

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    2014-11-30 smallant2015
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    2015-05-02 baoya
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    2015-10-10 achengzhao
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    2015-06-08 ljjj1053

    好好学习学习

    0

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    2014-11-02 hongbochen

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