阿托伐他汀对糖耐量低减伴高胆固醇血症的干预作用

目的观察阿托伐他汀对糖耐量低减(IGT)伴高胆固醇血症的干预作用。方法将新诊断的IGT伴高胆固醇血症88例分为阿托伐汀组和对照组。对照组进行一般的健康教育,每3个月进行饮食指导,阿托伐他汀组除与对照组同样处理外,另给予阿托伐他汀片10mg/d。两组受试者每3个月进行1次葡萄糖耐量试验(OGTT),并同时测定空腹胆固醇、胰岛素、肝肾功能、CRP、HOMA-IR,观察期为1年。观察中若75gOGTT结果为糖尿病者,则判断已转变为糖尿病。结果观察1年后,对照组转变为糖尿病4例(10.0%),阿托伐他汀组2例(4.2%),经χ2检验,阿托伐他汀干预后IGT转化为糖尿病率明显低于对照组(p<0.05)。干预前后TC、CRP及HOMA-IR对照组无明显变化(p>0.05),而阿托伐他汀组明显下降(p<0.05)。结论阿托伐他汀在延缓伴有高胆固醇血症的IGT向2型糖尿病发展中是有效的,其机制可能同它增强胰岛素敏感性及抗炎作用有关。

Objective To observe The intervention of atorvastatin on impaired glucose tolerance （IGT） combining with hypercholesteremia, Methods Divided the 88 patients with the diagnosis of IGT confining with hypercholesteremia （ the diagnasis of IGT was according to the diagnostic cede of WHO in 1999, tata I cholesterol （TC） 〉 6,5mmol/l ） into two groups ： 40 in control group , 26 male and 14 female , age （55 ± 10.2 岁 ）;48 in atorvastatin .group , 30 male and 18 female , age（56 ± 10.3 岁 ） o General education on health was provided to control group and instruction on food and drink was provided every 3 months . In atorvastatin group , besides the same instruction as provided in the control group , atorvastatin was administered with the dose 10nag/d, OGIT was checked every 3 months in both groups, fasting cholesterol, insuline level ,liver function and renal function ,CRP,HOMA - IR was also tested for totally one year . During the observation , if the results of OGTT with 75g showed diabetes , confimnation of diabetes is then made. Results After one year of observatian , there were 4 patients who turned to be diabetic , while in the atorvastatin group , there were 2 （4.2%）, X2 test showed the rate of IGT taming into diabetic ＇after interference by atorvastatin was much lower than that of the control, group （p 〈 0,05）. There was no marked change of TC,CRP and HOMA - IR in patients of control group before and after interference （ p 〈 0.05 ）, while in atorvastatin group , the level of TC, CRP and HOMA - IR dropped notably and the difference was significant coropared with that of before interference（p 〈 0.05）. Conclusion Atorvastatin is effective in preventing IGT combining with hypercholesteremia from progressing into diabetes type Ⅱ , the mechanism might be that it enhances the sensitivity to insulin and its anti - inflammatory effect.