老年2型糖尿病患者应用罗格列酮治疗前后血清C反应蛋白的改变

Changes of C-reactive protein level in elderly patients with type 2 diabetes after treatment with rosiglitazone

目的观察盐酸罗格列酮治疗老年2型糖尿病(T2DM)前后血清高敏C反应蛋白(hsCRP)的变化及其影响因素,探讨糖脂代谢与炎症因子的关系。方法将85例已合用磺脲类和双胍类药物的T2DM患者随机分为盐酸罗格列酮组(4mg/d)及对照组,进行为期12周的临床观察。结果基线hsCRP水平与糖化血红蛋白(HbA1c)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)水平、体质指数均相关。罗格列酮治疗后患者hsCRP水平明显下降(P=0.003)。而对照组无改变。餐后血糖变化(P<0.01)及空腹血糖水平的变化(P<0.01)与hsCRP变化最相关,其次为LDL-C(P<0.01)、HbA1c(P=0.031)及HDL-C(P=0.045)的改变。结论老年T2DM患者慢性高血糖状态与炎症关系密切。罗格列酮治疗在改善糖脂代谢的同时,还具有明显的抗炎作用使hsCRP水平明显下降。

Objective To observe the changes of serum high sensitivity C-reactive protein（hsCRP） level in elderly patients with type 2 diabetes after treatment with rosiglitazone and investigate the relationships between inflammatory factors and metabolism of glucose and lipid. Methods A 12-week randomized, double-blind, placebo controlled study was performed to compare the effects of placebo and rosiglitazone 4 mg/d in 85 cases of type 2 diabetic who had received metformin and sulfonylureas treatment. Results Baseline hsCRP level was correlated with the levels of glycosylated hemoglobin（HbA1c） ,high-density lipoprotein cholesterol（ HDL-C）, and low-density lipoprotein cholesterol（LDL-C）, body mass index（BMI）. A significant reduction in hsCRP level was observed during treatment with rosiglitazone （P = 0. 003）. In the placebo-treated patients the hsCRP level varied non-significantly. The overall effect of rosiglitazone on changes in hsCRP was associated with the changes in postprandial plasma glucose （P〈0. 01）, fasting plasma glucose （P 〈 0. 01）, LDL-C （P〈0. 01）, HbA1c （P = 0.031） and HDL-C （P = 0. 045）. Conclusions Close link between long-term hyperglycemia and inflammation in type 2 diabetes was suggested. A significant reduction in hsCRP level indicates that rosiglitazone possess anti-inflammatory properties.