马来酸罗格列酮对非糖尿病代谢综合征患者糖脂代谢及炎症的影响

Effects of rosiglitazone on metabolic disorder and inflammation in nondiabetic patients with metabolic syndrome

目的观察马来酸罗格列酮对非糖尿病代谢综合征(MS)患者糖脂代谢、胰岛素抵抗(IR)及血清炎症标志的影响。方法86例非糖尿病、伴高密度脂蛋白胆固醇(HDL-C)降低的MS患者随机分为两组,分别给予马来酸罗格列酮4mg/d或8mg/d治疗12周。比较治疗前后血糖、血脂、胰岛素抵抗指数(HOMA-IR)、血清高敏C反应蛋白(hsC-RP)、纤维蛋白原(FIB)和外周血白细胞数(WBC)的变化。结果两组治疗后空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1C)、空腹胰岛素(FIns)、HOMA-IR、甘油三酯(TG)、hsC-RP、FIB和WBC数均下降,HDL-C升高(P<0.05),8mg组的变化更明显;总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)在两组均无明显变化(P>0.05)。结论对伴有HDL-C降低和MS的非糖尿病患者,罗格列酮治疗呈剂量依赖的改善糖脂代谢、减轻IR和炎症状态。

Objective To evaluate the effects of rosiglitazone therapy on plasma glucose and lipids, insulin resistance and serum inflammatory factors in nondiabetic patients with metabolic syndrome（MS）. Methods Eighty-six nondiabetic patients with low HDL-C and MS were randomly allocated into two groups and treated for 12 weeks with rosiglitazone 4 mg（group A） or 8 mg（group B） daily. The lipids profile, HOMA-IR and inflammatory markers were compared before and after treatment. Results After treatment, FPO, 2 hPG, HbAxc, Fins, HOMA-IR, TG, hsC-RP, FIB and WBC counts were decreased and HDL-C increased significantly in both groups（P〈（0. 05）, which were changed more in group B than those in group A. The levels of TC and LDL-C were not Significantly changed after treatment（P〉0. 05）. Conclusion In nondiabetic patients with low HDL-C and MS, rosiglitazone can dose-dependantly improve plasma glucose and lipids, lesson insulin resistance and inflammatory state.