• 1. 中南大學(xué)湘雅二醫(yī)院代謝內(nèi)分泌研究所,長(zhǎng)沙,4100112. 中南大學(xué)湘雅二醫(yī)院超聲診斷科;

目的 　探討維生素E(VE)對(duì)新診2型糖尿病(T2DM)患者亞臨床動(dòng)脈粥樣硬化(AS)發(fā)生的影響.
方法 　選擇新診T2MD患者85例,采用隨機(jī)數(shù)字表法隨機(jī)分為VE組和對(duì)照組,1年期間失訪3例,實(shí)際納入分析82例,VE組和對(duì)照組各41例.兩組均采用抗血小板聚集、強(qiáng)化血糖、血壓、血脂、體重等綜合達(dá)標(biāo)的干預(yù)措施;VE組加服VE膠囊 200 mg/d,比較其干預(yù)1年對(duì)亞臨床AS發(fā)生的影響.
結(jié)果 　兩組間年齡、性別、基線體重指數(shù)、腰臀比、血脂、血壓、24h尿白蛋白、胰島素抵抗指數(shù)、高敏C-反應(yīng)蛋白水平、頸總動(dòng)脈、股動(dòng)脈及髂總動(dòng)脈內(nèi)中膜厚度(IMT)等比較均無(wú)顯著性差異(P gt;0.05).干預(yù)1年后,VE組頸總動(dòng)脈IMT下降幅度大于對(duì)照組(P lt;0.05),其余上述代謝指標(biāo)干預(yù)1年下降幅度差異無(wú)顯著性(P gt;0.05).干預(yù)1年后,VE組亞臨床AS的發(fā)生(26.8%,11/41)高于對(duì)照組(7.3%,3/41)(P lt;0.05).
結(jié)論 　口服補(bǔ)充VE 1年對(duì)采用多因素干預(yù)的新診T2DM患者亞臨床AS的發(fā)生無(wú)保護(hù)作用.

引用本文： 陳小燕,周智廣,唐煒立,周啟昌,李霞,顏湘,彭健,劉志文. 維生素E對(duì)新診2型糖尿病亞臨床動(dòng)脈粥樣硬化發(fā)生的影響. 中國(guó)循證醫(yī)學(xué)雜志, 2004, 04(7): 460-463. doi: 復(fù)制

1. ［1］Terasawa Y,Ladha Z,Leonard SW,Morrow JD,Newland D,Sanan D.Increased atherosclerosis in hyperlipidemic mice deficient in alpha-tocopherol transfer protein and vitamin E[J].Proc Natl Acad Sci USA,2000; 97(25):13 830-13 834.
2. ［2］Pryor WA.Vitamin E and heart disease:basic science to clinical intervention trials[J].Free Radic Biol med,2000; 28(1):141-164.
3. ［3］Salonen JT,Nyyssonen K,Salonen R,Lakka HM,Kaikkonen J,Porkkala-Sarataho E.Antioxidant Supplementation in Atherosclerosis Prevention(ASAP) study:a randomized trial of the effect of vitamins E and C on 3-year progression of carotid atherosclerosis[J].J Intern Med,2000; 248(5):377-386.
4. ［4］Haidara M,Khloussy H,Ammar H,Aal Kassem LA.Impact of α-tocopherol and vitamin C on endothelial markers in rats with streptozotocin-induced diabetes[J].Med Sci Monit,2004; 10(2):BR41-46.
5. ［5］Regensteiner JG,Popylisen S,Bauer TA,Lindenfeld J,Gill E,Smith S.Oral L-arginine and vitamins E and C improve endothelial function in women with type 2 diabetes[J].Vasc Med,2003; 8(3):169-175.
6. ［6］Munteanu A,Zingg JM,Azzi A.Anti-atherosclerotic effects of vitamin E-myth or reality[J].J Cell Mol Med,2004; 8(1):59-76.
7. ［7］Heitzer T,Schlinzig T,Krohn K,Meinertz T,Munzel T.Endothelial dysfunction,oxidation stress,and risk of cardiovascular events in patients with coronary artery disease[J].Circulation,2001; 104(22):2 673-2 678.
8. ［8］Upritchard JE,Sutherland WHF,Mann JI.Effect of supplementation with tomato juice,vitamin E,and vitamin C on LDL oxidation and products of inflammatory activity in type 2 diabetes[J].Diabetes Care,2000; 23(6):733-738.
9. ［9］Yusuf S,Dagenais G,Pogue J,Bosch J,Sleight P.Vitamin E supplementation and cardiovascular events in high-risk patients:the Heart Outcomes Prevention Evaluation Study Investigators[J].N Engl J Med,2000; 342(3):154-160.
10. ［10］Lonn E,Yusuf S,Dzavik V,Ian Doris C,Yi Q,Smith S.Effects of ramipril and vitamin E on atherosclerosis:the study to evaluate carotid ultrasound changes in patients treated with ramipril and vitamin E (SECURE)[J].Circulation,2001; 103(7):919-925.
11. ［11］Terentis AC,Thomas SR,Burr JA,Liebler DC,Stocker R.Vitamin E oxidation in human atherosclerotic lesions[J].Circ Res,2002; 90(3):333-339.
  1. 1. ［1］Terasawa Y,Ladha Z,Leonard SW,Morrow JD,Newland D,Sanan D.Increased atherosclerosis in hyperlipidemic mice deficient in alpha-tocopherol transfer protein and vitamin E[J].Proc Natl Acad Sci USA,2000; 97(25):13 830-13 834.
  2. 2. ［2］Pryor WA.Vitamin E and heart disease:basic science to clinical intervention trials[J].Free Radic Biol med,2000; 28(1):141-164.
  3. 3. ［3］Salonen JT,Nyyssonen K,Salonen R,Lakka HM,Kaikkonen J,Porkkala-Sarataho E.Antioxidant Supplementation in Atherosclerosis Prevention(ASAP) study:a randomized trial of the effect of vitamins E and C on 3-year progression of carotid atherosclerosis[J].J Intern Med,2000; 248(5):377-386.
  4. 4. ［4］Haidara M,Khloussy H,Ammar H,Aal Kassem LA.Impact of α-tocopherol and vitamin C on endothelial markers in rats with streptozotocin-induced diabetes[J].Med Sci Monit,2004; 10(2):BR41-46.
  5. 5. ［5］Regensteiner JG,Popylisen S,Bauer TA,Lindenfeld J,Gill E,Smith S.Oral L-arginine and vitamins E and C improve endothelial function in women with type 2 diabetes[J].Vasc Med,2003; 8(3):169-175.
  6. 6. ［6］Munteanu A,Zingg JM,Azzi A.Anti-atherosclerotic effects of vitamin E-myth or reality[J].J Cell Mol Med,2004; 8(1):59-76.
  7. 7. ［7］Heitzer T,Schlinzig T,Krohn K,Meinertz T,Munzel T.Endothelial dysfunction,oxidation stress,and risk of cardiovascular events in patients with coronary artery disease[J].Circulation,2001; 104(22):2 673-2 678.
  8. 8. ［8］Upritchard JE,Sutherland WHF,Mann JI.Effect of supplementation with tomato juice,vitamin E,and vitamin C on LDL oxidation and products of inflammatory activity in type 2 diabetes[J].Diabetes Care,2000; 23(6):733-738.
  9. 9. ［9］Yusuf S,Dagenais G,Pogue J,Bosch J,Sleight P.Vitamin E supplementation and cardiovascular events in high-risk patients:the Heart Outcomes Prevention Evaluation Study Investigators[J].N Engl J Med,2000; 342(3):154-160.
  10. 10. ［10］Lonn E,Yusuf S,Dzavik V,Ian Doris C,Yi Q,Smith S.Effects of ramipril and vitamin E on atherosclerosis:the study to evaluate carotid ultrasound changes in patients treated with ramipril and vitamin E (SECURE)[J].Circulation,2001; 103(7):919-925.
  11. 11. ［11］Terentis AC,Thomas SR,Burr JA,Liebler DC,Stocker R.Vitamin E oxidation in human atherosclerotic lesions[J].Circ Res,2002; 90(3):333-339.