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[目的]研究肥胖2型糖尿病患者血管内皮功能的影响因素及吡格列酮的治疗作用。[方法]新诊断肥胖2型糖尿病患者30例,正常对照组25例,治疗前后分别检测血清APN、HOMA-IR、TG、HDL、BMI,同时利用超声检测反应性充血肱动脉内径增加程度FMD。[结果]肥胖2型糖尿病患者FMD及APN水平较正常对照明显降低,吡格列酮治疗后FMD显著改善(7.15±3.20vs10.36±4.55,P﹤0.01)、APN升高[(6.94±2.58)mg/Lvs(9.77±3.16)mg/L,P﹤0.01]。多元相关分析显示,FMD与APN、HDL呈显著正相关(r=0.592,r=0.306,P﹤0.01),与FBG、HOMA-IR呈负相关(r=-0.285,r=-0.291,P﹤0.01),与年龄、性别、BMI、TG无关。[结论]2型糖尿病患者存在明显的内皮功能紊乱及低脂联素血症,吡格列酮可通过多种途径起到改善血管内皮功能的作用。
[Objective] To investigate the influencing factors of vascular endothelial function in obese type 2 diabetic patients and the therapeutic effect of pioglitazone. [Methods] 30 newly diagnosed obese patients with type 2 diabetes mellitus and 25 normal controls were enrolled in this study. Serum APN, HOMA-IR, TG, HDL and BMI were measured before and after treatment. Meanwhile, the increase of FMD was detected by ultrasound. [Results] The levels of FMD and APN in obese type 2 diabetic patients were significantly lower than those in normal controls (P <0.01). The APD was significantly higher in patients with type 2 diabetes mellitus (7.15 ± 3.20 vs 10.36 ± 4.55, P <0.01) Lvs (9.77 ± 3.16) mg / L, P <0.01]. Multivariate correlation analysis showed that there was a significant positive correlation between FMD and APN and HDL (r = 0.592, r = 0.306, P <0.01), but negatively correlated with FBG and HOMA-IR 0.01), with age, gender, BMI, TG has nothing to do. [Conclusion] There are obvious endothelial dysfunction and hypocalcemia in patients with type 2 diabetes. Pioglitazone may play a role in improving vascular endothelial function through a variety of pathways.