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目的观察2型糖尿病患者血糖正常的一级亲属(试验组:A组)血管内皮功能受损及血小板活化状况。方法检测A组、健康对照组(B组)和葡萄糖耐量受损组(IGT组:C组)各30例的内皮素(ET)、血管性血友病因子(vWF)、血小板活化因子(PAF)水平,并进行统计分析。结果试验组ET,vWF,PAF 3项指标水平均显著高于B组(P<0.01),同时也高于C组,说明A组血管内皮功能受损、血小板活化先于血糖升高,而且可能与遗传因素关系更大。结论内皮功能损伤存在于有2型糖尿病家族史但血糖正常的一级亲属以及IGT患者中。ET,vWF,PAF 3项指标的变化出现在糖代谢异常之前,提示糖尿病一级亲属在未发生糖尿病之前,血管内皮功能损伤已启动,除了生活因素和环境因素对血管内皮功能的影响外,遗传因素可能在2型糖尿病血糖正常的一级亲属中启动内皮功能受损、血小板活化过程中起着重要作用,值得进一步研究。在ET,vWF水平升高的同时,PAF水平也伴随升高,即不仅明显高于健康对照组,同时也高于IGT对照组,提示血小板活化共同参与了血管内皮功能受损的病理生理过程,并且在糖尿病及其并发症的发生、发展进程中起着重要的作用。
Objective To observe the impaired vascular endothelial function and platelet activation in first-degree relatives with type 2 diabetes mellitus (group A: normal blood glucose). Methods The ET, VWF and PAF levels in 30 patients in group A, healthy control group (B) and impaired glucose tolerance group (IGT group: C) ) Level, and statistical analysis. Results The levels of ET, vWF and PAF in the experimental group were significantly higher than those in the B group (P <0.01) and also higher than those in the C group, indicating that the vascular endothelial function was impaired and the platelet activation was earlier than that of the elevated blood glucose in the experimental group A And genetic factors more. Conclusions Endothelial dysfunction occurs in first-degree relatives with a family history of type 2 diabetes but with normal glucose levels and in patients with IGT. ET, vWF, PAF changes in three indicators before the abnormal glucose metabolism, suggesting that diabetic first-degree relatives in the absence of diabetes before vascular endothelial dysfunction has been started, in addition to living factors and environmental factors on vascular endothelial function, genetic Factors may initiate endothelial dysfunction in first-degree relatives of type 2 diabetic patients with normal blood glucose and play an important role in platelet activation and deserve further study. At the same time of ET and vWF, the level of PAF was also increased, which was not only higher than that of healthy control group, but also higher than that of IGT control group, suggesting that platelet activation was involved in the pathophysiological process of impaired endothelial function, It plays an important role in the occurrence and development of diabetes mellitus and its complications.