胰岛素联合罗格列酮治疗对糖尿病患者血浆醛固酮的作用

The effect of rosiglitazone combined with insulin on plasma aldosterone in diabetes patients

目的通过比较糖尿病患者胰岛素联合罗格列酮治疗前后血浆醛固酮水平的变化,探讨罗格列酮导致水肿的机制。方法 2型糖尿病患者单独使用胰岛素治疗半年以上的患者随机分为两组,罗格列酮联合胰岛素治疗组在目前胰岛素治疗基础上加用罗格列酮4mg/日(n=10),胰岛素组继续胰岛素治疗(n=10)。分别于治疗前、治疗后2、4、6个月测定立位血浆醛固酮水平,监测患者水肿情况及体重。结果罗格列酮可以导致水肿、体重增加。罗格列酮联合胰岛素治疗组血浆醛固酮水平2个月时较对照组有升高的趋势(P>0.05);治疗4个月时显著高于对照组(P<0.05);至6个月时罗格列酮联合胰岛素治疗组血浆醛固酮水平较前下降,与胰岛素组无统计学差异(P>0.05)。结论罗格列酮治疗早期出现的水肿可能与血浆醛固酮水平升高有关。

Objective To investigate if edema caused by rosiglitazone is associated with the change of aldosterone level. Methods Plasma aldosterone levels in different periods from patients treated with rosiglitazone combined with insulin were measured. Type 2 diabetes patients who have been treated with insulin alone were divided into two groups： patients treated with rosiglitazone（4mg/d） combined with insulin（RSG＋ insulin group）, or treated with insulin alone （insulin group）（n= 10）. Aldosterone levels, incidence of edema and weight gain were monitored every two months during six months. Results The incidence of edema and weight gain were higher in RSG＋insulin group than in insulin group. After two months, aldosterone levels were higher in RSG＋ insulin group than in insulin group [ （77. 8 ± 25.9） vs （60. 2± 27. 6） pg/ml, P〉 0.05 ], but it had no statistical difference; after four months, aldosterone levels were higher in RSG＋insulin group than in insulin groupE（87. 2 ± 27.1） vs （61.5 ± 25.6） pg/ml, P〈0. 05]. After six months, aldosterone level recovered gradually, it had no statistical difference compared with that of control[ （ 77.0 ± 21.0） vs （ 69. 6± 21. ？7） pg/ml, P〉0. 05]. Conelmions The cause of early edema in type 2 diabetic patients treated with rosiglitazone combined with insulin was probably assosiated with elevated aldosterone level.