摘要
目的观察盐酸吡格列酮治疗2型糖尿病(T2DM)前后血清高敏C反应蛋白(hsCRP)的变化及其影响因素,探讨糖脂代谢与炎症因子的关系。方法采用随机、双盲、安慰剂平行对照方法将130例已合用磺脲类和双胍类药物的T2DM患者随机分至盐酸吡格列酮组及安慰剂组,进行为期12周的临床观察。结果基线hsCRP水平与糖化血红蛋白(HbA1c)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、甘油三酯(TG)水平、体质指数、性别均相关。吡格列酮治疗后患者hsCRP水平明显下降(P=0.0030)。而安慰剂组无改变。餐后血糖变化(P<0.01)及空腹血糖水平的变化(P<0.01)与hsCRP变化最相关,其次为LDLC(P<0.01)、HbA1c(P=0.033)及HDLC(P=0.047)的改变。结论T2DM患者慢性高血糖状态与炎症关系密切。吡格列酮治疗在改善糖脂代谢的同时,还具有明显的抗炎作用,使hsCRP水平明显下降。
Objective To observe the changes in serum high sensitivity C-reactive protein (hsCRP) in patients with type 2 diabetes after treatment with pioglitazone and investigate the relationships of inflammatory factors with the metabolism of glucose and lipid. Methods A 12-week randomized, double-blind, placebo controlled study was performed to compare the effects of placebo and pioglitazone 30 mg/d in 130 type 2 diabetic patients who had received metformin and sulfonylureas treatment. Results The baseline hsCRP level was correlated with the levels of glycosylated hemoglobin (HbA_1c), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), body mass index (BMI) and gender. Females had higher hsCRP levels. A significant reduction in hsCRP level was observed during treatment with pioglitazone (P=0.003). In the placebo-treated patients the hsCRP level varied non-significantly. The overall effect of pioglitazone on changes in hsCRP was associated with the changes in postprandial plasma glucose (P<0.01), fasting plasma glucose (P<0.01), LDL-C (P<0.01), HbA_1c (P=0.033) and HDL-C (P=0.047). Conclusion There is a close link between long-term hyperglycemia and inflammation in type 2 diabetes. A significant reduction in hsCRP levels suggests that pioglitazone possess anti-inflammatory properties.
