【摘要】 目的 探讨2型糖尿病(T2DM)患者脂肪餐后肱动脉血流介导的血管舒张功能(FMD)变化及与氧化应激、脂代谢动态的关系。方法 选取2019年1月—2022年3月收治的125例T2DM患者(T2DM组)及体检中心125例健康人群(对照组)为研究对象，均给予脂肪餐，比较两组餐前和餐后2、4 h的血糖、氧化应激指标[超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)]、脂代谢指标[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)]的变化，采用Pearson分析餐前和餐后2、4 h的FMD与血糖、氧化应激指标和脂代谢指标的关系。结果 T2DM组餐前和餐后2、4 h的血糖水平[(8.64±0.59)、(13.15±1.36)、(8.72±0.63)mmol/L]均高于对照组[(5.02±0.32)、(7.32±0.25)、(4.96±0.29)mmol/L](P<0.05);SOD和GSH-Px均低于对照组，MDA均高于对照组(P<0.05);TC、TG和LDL-C均高于对照组，HDL-C均低于对照组(P<0.05);FMD为[(6.57±1.13)%、(3.60±0.97)%、(3.27±0.65)%],均低于对照组[(8.15±1.09)%、(6.53±1.16)%、(7.89±1.22)%](P<0.05)。餐前和餐后2、4 h的FMD与对应时间点的SOD、GSH-Px、HDL-C呈正相关，与对应时间点的血糖、MDA、TC、TG、LDL-C呈负相关(P<0.05)。结论 T2DM患者FMD受损，负荷脂肪餐后血管内皮调节能力与氧化应激、脂代谢调控能力减弱，不能及时恢复至餐前水平，且血管内皮功能与氧化应激和血脂变化有关。更多还原

【Abstract】 Objective To investigate the dynamic changes of oxidative stress and lipid metabolism after standard fat meals in patients with type 2 diabetes(T2 DM), as well as brachial artery blood flow-mediated vasodilation(FMD). Methods 125 T2 DM patients(T2 DM group) and 125 healthy people in the physical examination center(control group) admitted to our hospital from January 2019 to March 2022 were selected and were given standard fat meals. The two groups were compared before and after meals, for 2 h, 4 h postprandial blood glucose, oxidative stress [superoxide dismutase(SOD), glutathione peroxidase(GSH-Px), malondialdehyde(MDA)], lipid metabolism [total cholesterol(TC), triacylglycerol(TG), low-density lipoprotein(LDL-C), high-density lipoprotein(HDL-C)] changes. With Pearson analysis, we analyzed blood glucose, oxidative stress before meals, 2 hours after meals, 4 hours after meals and the relationship between stimulus, lipid metabolism indexes and FMD. Results The blood glucose [(8.64±0.59),(13.15±1.36),(8.72±0.63) mmol/L] before a meal, 2 hours after a meal, and 4 hours after a meal in the T2 DM group were higher than that of the control group [(5.02±0.32),(7.32±0.25),(4.96±0.29) mmol/L](P<0.05). SOD and GSH-Px in the T2 DM group before, 2 h, and 4 h after a meal were lower than those of the control group, and MDA was higher than the control group(P<0.05); TC, TG, LDL-C before meals, 2 hours after meals and 4 hours after meals in T2 DM group were higher than those in the control group, while HDL-C was lower than those in the control group(P<0.05); before and after meals in the T2 DM group. FMD at 2 h and 4 h after meal were(6.57±1.13)%,(3.60±0.97)%,(3.27±0.65)%, which were lower than the control group(8.15±1.09)%,(6.53±1.16)%,(7.89±1.22)%(P<0.05). SOD, GSH-Px, HDL-C are positively correlated with FMD at the corresponding time point before meal, 2 hours after meal, 4 hours after meal, and FMD before meal, 2 hours after meal, and after meal blood glucose, MDA, TC, TG, LDL-C at 4 h were negatively correlated with FMD at the corresponding time point(P<0.05). Conclusion The ability of T2 DM patients to regulate postprandial oxidative stress and lipid metabolism is weakened and cannot be restored to pre-prandial levels in time. Oxidative stress and changes in blood lipids are related to vascular endothelial function.更多还原