罗格列酮对不同糖耐量者的内皮障碍的影响

Endothelium dysfunction in subjects with various glucose tolerances and effect of rosiglitazone intervention

目的探讨不同糖耐量者内皮障碍及罗格列酮对这一障碍的影响。方法应用罗格列酮(4mg/d,16周)治疗IFG、IGT及2型糖尿病病人并观察其对内皮损伤的标记物:尿白蛋白排泄率(UAER)、I型血浆纤溶酶原活化抑制剂(PAI-1)、假性血友病因子(vWF)、血浆血栓调节蛋白(TM)的影响。结果IFG、IGT及2型糖尿病的UAER、PAI-1、TM均较对照组明显增高(P<0.05或P<0.01)。2型糖尿病组的vWF较对照组明显增高(P<0.05)。2型糖尿病组的UAER、PAI-1、TM较IFG和IGT组也明显增高(P<0.05或P<0.01)。经罗格列酮治疗后UAER、PAI-1、vWF、TM水平呈不同程度的下降,且多具有显著意义。结论罗格列酮可以改善胰岛素抵抗所致的内皮功能障碍,对减少大血管病变的发生有积极的作用。

[Objective] To investigate the endothelium dysfunction in subjects with various glucose tolerances and the effect of rosiglitazone(RSG) intervention. [Methods] A total of subjects participated in the study were divided into four groups according to oral 75 g glucose tolerance test (OGTT). They were normal glucose tolerance (NGT) group, impaired fasting glucose(IFG), impaired glucose tolerance (IGT) and type 2 diabetes (T2DM) group. The patients of IFG, IGT and T2DM received 4 mg RSG daily for 16 weeks respectively. The markers of endothelium dysfunction including rates of urinary albumin excretion(UAER), Von willebrand factor(vWF), plasminogen activator inhibitor type-1(PAI-1), Thrombomodulin(TM)were detected. [Results] The levels of UAER, PAI-1, TM in IFG, IGT and T2DM groups were significantly higher than in NGT group (P <0.05 or P <0.01), the levels of vWF in T2DM group were significantly higher than in NGT group(P <0.05), and the levels of UAER, PAI-1, TM in T2DM group were significantly higher than in IFG and IGT groups (P <0.05 or P <0.01). Their levels were decreased to varying degrees after treatment with RSG for 16 weeks, and most of the decline were significant. [Conclusion] Rosiglitazone effectively suppresses the endothelium dysfunction of the patients of IFG, IGT and T2DM.