吡格列酮对老年糖耐量低减患者颈动脉硬化的影响

Effect of Pioglitazone on Carotid Atherosclerosis in Old-Aged Impaired Glucose Tolerance Patients

目的探讨吡格列酮对老年糖耐量低减(IGT)患者颈动脉硬化的影响。方法选取48例老年糖耐量正常者(NGT)及64例老年糖耐量低减患者(IGT),测定并比较颈动脉内中膜厚度(CCAIMT);将IGT患者随机分为2组,各32例,进行12个月治疗:对照组,仅改变生活模式;吡格列酮组,改变生活模式基础上服吡格列酮(每天30mg),观察治疗前后CCAIMT的变化。结果 CCAIMT在IGT患者明显高于NGT个体;IGT患者治疗前CCAIMT在对照组和吡格列酮组无明显差异,治疗12个月后CCAIMT在对照组无明显变化,在吡格列酮组显著降低,两组差异有统计学意义(P<0.05),且CCAIMT变化值与胰岛素抵抗指数(HOMA-IR)变化值、高敏感C反应蛋白(HsCRP)变化值、甘油三酯(TG)变化值呈正相关。结论应用吡格列酮可延缓老年IGT患者颈动脉硬化进展。

OBJECTIVE To investigate the effects of pioglitazone on carotid atherosclerosis in old-aged impaired glucose tolerance （IGT） patients.METHODS According to 75 g OGTT test,48 cases of normal glucose tolerance （NGT） old-aged patients and 64 cases of IGT patients were selected.Then IGT patients were randomly enrolled into two groups with different treatment for 12 months.Patients in control group underwent an individually designed diet and exercise program,while those in pioglitazone group were treated with pioglitazone （30 mg·d^-1） on the basis of treatment of control group.Carotid intima-media thickness （CCAIMT）,fasting and postprandial blood glucose （FBG and PBG）,hemoglobin A1c（Hb A1c ）,the serum level of lipid and high-sensitive C reaction protein （HsCRP） were measured.RESULTS Compared with NGT patients,CCAIMT in IGT patients was increased significantly.CCAIMT was similar between control group and pioglitazone group before treatment.After 12 months,they were decreased in pioglitazone group and did not change in the control group.There are significant differences between two groups （P〈0.05）.Moreover,the changes of CCAIMT was positively correlated with the changes of homeostasis model assessment insulin resistance index （HOMA-IR）,HsCRP and triglyceride （TG）.CONCLUSION Pioglitazone can delay the progression of carotid atherosclerosis in old-aged IGT patients.