阿卡波糖对糖耐量减低者早期干预的影响

Effect of acarbose intervention on cases with impaired glucose tolerance

目的比较不同糖耐量水平者颈动脉内膜-中层厚度(IMT)和血清C-反应蛋白(CRP)水平;观察糖耐量减低(IGT)者应用阿卡波糖早期干预后的变化。方法256例受试者,行口服75g葡萄糖耐量试验(OGTT)并以1997年ADA定义分三组:糖耐量正常(NGT)组、糖调节受损(IGR)组和2型糖尿病(T2DM)组。测定颈动脉IMT及血清CRP浓度。将IGR组中的IGT及空腹血糖受损(IFG)+IGT患者随机分为治疗组(应用阿卡波糖)和对照组。结果(1)三组颈动脉IMT和血清CRP水平逐渐升高(P<0.05),Spearman等级相关分析显示颈动脉IMT及血清CRP浓度和糖耐量水平呈负相关(P<0.01)。(2)治疗16周后,治疗组与对照组相比颈动脉IMT及血清CRP浓度差异有统计学意义(P<0.01)。结论IGR程度越重,动脉粥样硬化(AS)病变也越重;对IGT患者使用阿卡波糖早期干预可能有益于减缓AS的发生和发展。

Objective To investigate the differences of carotid intimamedia thickness （IMT） and serum C -reactive protein（CRP） concentrations in-subjects with various glucose tolerances and the changes in cases of impaired glucose tolerance（IGT） treated with acarbose. Methods A total of 256 subjects participated in the study were grouped NGT, IGR and T2DM based on the definition from ADA in 1997 by OGTI＇. The carotid IMT was assessed and serum CRP concentrations were measured the same day. The cases of IGT and IGT ＆ IFG subgroups in IGR were recruited into another study and acarbose or placebo was prescribed for 16 weeks. Results （1） The average levels of carotid IMT and serum CRP in IGR were higher than those in NGT, and compared with IGR group,those of T2DM also increased significantly（P 〈0.05）. Spearman rank correlation analysis showed that carotid IMT and serum CRP concentration （P 〈 0.01 ） were negatively correlated with glucose tolerance level. （2） Sixteen weeks later after acarbose therapy,there were significant differences between the treatment group and placebo group on ca- rotid IMT and serum CRP （ P 〈 0.01 ）. Conclusions The degree of artherosclerosis （AS） increases gradually in accordance with the worsening of glucose regulation. It may be beneficial for IGT subjects to receive acarbose therapy earlier in delaying footstep of AS.