吡格列酮对初诊2型糖尿病患者颈动脉内膜中层厚度的影响

Effects of pioglitazone on carotid intima-media thickness in newly diagnosed type 2 diabetic patients

目的:探讨吡格列酮对初诊2型糖尿病患者颈动脉内膜中层厚度(Carotid intima-media thickness,CIMT)的影响,分析其抑制动脉粥样硬化的可能机理。方法:62例初诊2型糖尿病患者随机分成吡格列酮治疗组(31例)与对照组(31例),治疗前后检测CIMT及相关生化指标。结果:吡格列酮治疗组治疗后,CIMT值显著下降(P<0.01),同时空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、血清hsCRP显著下降(P<0.01)。而对照组除FPG和HbA1c下降具统计学意义(P<0.01)外,其他各项指标无明显变化(P>0.05)。结论:吡格列酮可能通过降低胰岛素抵抗及抗炎作用而显著降低初诊2型糖尿病患者CIMT水平,抑制糖尿病患者早期动脉粥样硬化的发生和发展。

Objective：To investigate the change of carotid intima-media thickness（CIMT） in newly diagnosed patients with type 2 diabetic in response to pioglitazone and to analyse a possible mechanism of anti-atherosclerosis effects of pioglitazone.Method：Sixty-two newly diagnosed type 2 diabetic patients were randomly enrolled into treatment group with pioglitazone and control group.The CIMT and some relative biochemical indicators were measured.Results：After treatment with pioglitazone,the CIMT,fasting plasma glucose（FPG）,hemoglobin A1c（HbA1c）,fasting insulin（FINS）,high sensitive C reactive protein（hsCRP） and insulin resistance index（HOMA-IR） decreased significantly（P〈0.01）.Most data had no marked changes in the control group（P〉0.05） but that the concentration of FPG and HbA1c were markedly lower than those before management（P〈0.01）.Conclusion：Pioglitazone slowed progression of CIMT in the newly diagnosed type 2 diabetic patients.Pioglitazone maybe delay the occurrence and development of atherosclerosis via the decreased insulin resistance and anti-inflammation actions.