罗格列酮对2型糖尿病患者颈动脉内膜厚度的影响

Influence of rosiglitazone on the carotid arterial intima-media wall thickness in type 2 diabetic mellitus patients

目的研究罗格列酮(抗动脉粥样硬化药)抗动脉粥样硬化作用及相关机制。方法2型糖尿病患者78例,分为试验组、对照组,试验组选用罗格列酮治疗,对照组继续原有治疗。12周后,测定2组空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、空腹胰岛素(FINS)、C反应蛋白(CRP),并计算胰岛素抵抗指数(IRI);测定双侧颈总动脉内膜厚度(IMT),计算0与12周之间各组变化值(△IMT)。结果2周后,试验组IMT明显下降;而对照组IMT明显增厚;2组△IMT相比较,差异具有显著性;试验组胰岛素抵抗指数、HbA1c、TC、TG、CRP均较干预前下降;以IMT为应变量进行相关分析,IMT与HOMA-IR、HbA1c、CRP、TC呈显著正相关,与TG无相关性。结论2型糖尿病患者动脉粥样硬化形成与胰岛素抵抗、炎症反应、高血糖及高胆固醇血症相关;而与高甘油三酯血症无关。罗格列酮可降低颈动脉内膜厚度。

Objective To study the antiatherogenic effects of rosiglitazone, in type 2 diabetic mellitus patients. Methods A total of 78 type 2 diabetic mellitus patients were included and divided into two groups： trial group （rosiglitazone 4 mg daily for 12 weeks） and the untreated control group. The changes in glyeolipid metabolism as well as plasma C -reactive protein （CRP）, the insulin resistance index （IRI） and carotid arterial intima- media wall thickness（IMT）, A IMT were monitored to analyze the antiatherogenie effects of rosiglitazone. Results The rosiglitazone treatment significantly decreased A IMT. There was a statistics significance between IMT of two groups. It also significantly decreased HOMA -IR, reduced hyperglycemia, hyperinsulinemia, HbAlc levels and decreased CRP relative to the control group . The IMT was associated with HOMA -IR, HbAle ,CRP and TC,while independent of TG. Conclusion The developing atheroslerosis in type 2 diabetes mellitus was associated with the insuline resistance, high blood glucose and high TC, while was not with TG. The carotid arterial intimamedia wall thickness was decreased after oral rosiglitazone.