目的 研究从糖耐量正常、糖耐量减低至糖尿病发展过程中可溶性血管细胞黏附分子-1(sVCAM-1)和可溶性细胞间黏附分子-1(sICAM-1)的变化,探讨二者与糖尿病早期动脉硬化颈动脉内膜中层厚度(IMT)的关系.方法 选取糖耐量正常者30例(NGT组)、糖耐量减低者50例(IGT组)、2型糖尿病(T2DM)患者55例(T2DM组),检测3组受试者血生化指标及sVCAM-1、sICAM-1水平,用超声检测颈动脉IMT.结果 NGT组、IGT组、T2DM组受试者血sVCAM-1、sICAM-1水平及颈动脉IMT逐渐增高,组间两两比较差异有统计学意义(P＜0.05).相关研究显示,颈动脉IMT与血清sVCAM-1、sICAM-1成正相关,sICAM-1和sVCAM-1与体质指数、餐后2 h血糖、三酰甘油及胰岛素抵抗指数均呈正相关(P＜0.05).结论 糖代谢异常早期即有炎症反应发生,并导致了血管内皮损伤,参与了糖尿病动脉硬化的整个进程.血清sVCAM-1和sICAM-1水平升高与肥胖、糖脂代谢异常及胰岛素抵抗有关.%Objective To investigate the changes of serum sVCAM - 1 and sICAM - 1 levels in normal glucose tolerance ( NGT ), impaired glucose tolerance ( IGT ) and type 2 diabetes mellitus ( DM ) patients, as well as the associations of these changes with early diahetic atherosclerosis which is mirrored hy the index of carotid intimal - medial thickness ( IMT ).Methods A total of 135 ( 30 NGT, 50 IGT and 55 DM ) subjects were enrolled, with their serum levels of sVCAM - 1 and sICAM-1 determined by biochemistry and carotid IMT measured by ultrasonics. Results Carotid IMT measurements, serum sVCAM-1 and sICAM-1 levels increased gradually in the order of NGT, IGT, and T2DM patients, with significant differences between any two groups ( P ＜ 0.05 ) . This study also revealed positive correlations between IMT and serum sVCAM - 1 , sICAM-1 levels; positive correlations between serum sVCAM-1, sICAM - 1 levels and body mass index ( BMI ), 2 - h plasma glucose ( 2 hPG ), triglyceride ( TG ) and homeostasis model assessment - insulin resistence ( HOMA - IR ) (P ＜ 0.05 ). Conclusion Inflammatory reaction plays an important role during the early stage of diabetic atherosclerosis and also during its progression. The elevation of serum sVCAM - 1 and sICAM - 1 levels is correlated with of ohesity , glycolipid metabolic disorder and insulin resistance.
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