吡格列酮改善糖尿病前期患者血管内皮细胞功能的研究

Study on pioglitazone's effect on ameliorating endothelial dysfunction in pre-diabetic patients

目的观察吡格列酮治疗糖尿病前期患者血管内皮细胞功能的变化及其可能的机制。方法41名年龄35～59岁的初诊糖尿病前期患者(6.1mmol/L≤FPG<7.0mmol/L和/或7.8mmol/L(2hPG<11.1mmol/L)患者,经改变生活方式1个月后,仍未达到或超过以上最低基线者,随机分为两组,分别给予吡格列酮15mg/d或安慰剂,疗程12周。观察治疗前后肱动脉血流、血管顺应性、血一氧化氮(NO)水平、血压、心率、体重指数、简化葡萄糖耐量试验、血胰岛素和血脂水平的变化。结果吡格列酮组治疗后血糖、胰岛素水平明显降低,血管顺应性改善,肱动脉血流和血NO明显增加,TG亦明显降低。与安慰剂组治疗后比较,以上指标差异均有显著性。血压、体重指数、TC和LDL等指标两组治疗前后以及组间比较差异均无显著性。结论吡格列酮治疗糖尿病前期患者,不但降低血糖改善胰岛素抵抗,而且改善内皮细胞功能,可能与NO合成增加有关。另外,TG亦明显降低。

Objective To study whether pioglitazone therapy ameliorates endothelial dysfunction in pre - diabetic patients and the meehanism of it. Methods 41 pre - diabetic patients were divided into two groups randomly. One group received pioglitazone 15mg/d for 12 weeks and the other was control group. Endothelial fimction was assessed by brachial artery diameter changes as endothelium- dependent and endathelian - independent vasodilation （EDV and EIV）. Blood nitric oxide （NO）, blood pressure, heart rate, body mass index, glucose tolerance test, blood insulin and lipid were also measured. Results After pioglitazone treatment, blood glucose, insulin and TG were decreased and EDV and NO were increased significantly. Compared with control group, these index changes were also significant. Conclusion Pioglitazone therapy not only decreases blood glucose, TG and increases insulin sensitivity, but also ameliorates endothelial dysfunction by NO release probably.