文迪雅对糖稳态受损的临床干预研究

The Clinical Intervention Study Of Rosiglitazone In The Patients With Impaired Glucose Homeostasis

目的探讨文迪雅(罗格列酮)对糖耐量减低(impaired glucose tolerance,IGT)或空腹血糖损害(impaired fasting glucose,IFG)(糖稳态受损)患者临床干预治疗的效果。方法本临床观察共设3组:罗格列酮治疗组(n=35)、饮食和运动治疗组(n=30)和对照组(n=33)。观察时间6个月。监测指标包括:体重指数(BMI)、空腹血糖(FPG)、餐后2小时血糖(2HPG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹胰岛素(FINS)等。结果(1)罗格列酮治疗组,干预治疗6个月后,BMI、FPG、2HPG、TC、TG、LDL-C、FINS等明显下降,差异具有统计学意义(p<0.05);(2)饮食和运动治疗组,坚持饮食控制和体育运动治疗6个月,BMI、FPG、2HPG、TC、TG、LDL-C等虽有不同程度的下降,但无统计学差异(p>0.05)。(3)对照组在给予安慰剂治疗6个月后,BMI、FPG、2HPG、TC、LDL-C、FINS等有上升趋势,但差异无统计学(p>0.05)。结论罗格列酮能降低FPG、2HPG及FINS水平,增强胰岛素敏感性,改善胰岛素抵抗,同时还能降低BMI,还同时能降低TC、TG、LDL-C,改善血脂代谢异常。因此对IGT或IFG患者在控制饮食、坚持体育运动的基础上,有必要给予罗格列酮干预治疗。

objective To investigate the clinical effect of rosiglitazone in the patients with impaired glucose tolerance（IGT） or impaired fasting glucose（IFG）.Methods The patients was divided into three groups randomly ： rosiglitazone therapy group （n=35）, rational diet and exercise group （n=30）, normal control group（n=33）.The period of observation was 6 months. The observed items included： the body mass index （BMI）, fasting plasma glucose （FPG）, postprandial 2 hours plasma glucose （2HPG）, total cholesterol（TO, total glycerin（TG）, high density lipoprotein cholesterol（HDL-c）, low density lipoprotein cholesterol（LDL-c ）, fasting insulin （FINS）. Results 1） After 6 months treatment, we found BMI, FPG, 2HPG, TC, TG, LDL-C,FINS were decreased sharply in rosiglitazone group, the difference had statistical significance （p〈0. 05）; 2）while BMI, FPG, 2HPG, TC, TG, LDL-C were declined very little and there were no statistical significance （p〉0. 05） in the rational diet and exercise group after 6 months;3） In normal control group, BMI, FPG、2HPG、TC、LDL-C, FINS trended to rise ,but they didn＇t have statistical significance （p〉0. 05）after administration of placebo 6 months later. Conclusion Rosiglitazone can decrease the levels of FPG,2HPG and FINS ,enhance the sensitivity of insulin, improve the insulin resistance, reduce BMI,TC, TG,LDL-c at the same time and improve the abnormal metabolism of lipid. So it is very necessary to administer rosiglitazone to the patients with IGT or IFG on the basis of rational diet and exercise.