吡格列酮的抗氧化作用对代谢综合征患者血管内皮细胞功能的影响

Pioglitazone treatment improves endothelial vasodilator function in patients with metabolic syndrome via inhibition of oxidative stress

目的:研究吡格列酮对伴糖耐量减低(impaired glucose tolerance,IGT)的代谢综合征(metabolic syndromic,MS)患者血管内皮细胞功能的影响。方法:对30例伴IGT的MS患者采用吡格列酮45 mg/d治疗8周。在治疗前后分别测定血浆胰岛素水平、胰岛素敏感度检测指数(quantitative insulin sensitivity check index,QUICKI);肱动脉内皮依赖性舒张功能(flow-mediated vasodilation,FMD)和硝酸甘油诱导的非内皮依赖性舒张功能(nitroglycerin-induced vasodilation,NID);丙二醛(malondialdehyde,MDA)及还原型谷胱甘肽(glutathione,GSH)改变。结果 :治疗后FMD明显改善(P<0.01),QUICKI指数升高(P<0.05);MDA水平降低(P<0.01),GSH轻度升高(P<0.05)。结论:吡格列酮能明显改善IGT的MS患者的血管内皮细胞功能,其机制可能与改善胰岛素抵抗及氧化应激反应有关。

Objective： This study tested the hypothesis that pioglitazone improves endothelial function in metabolic syndromic subjects（MS） with impaired glucose tolerance（IGT）.Methods： 30 metabolic syndromic patients with impaired glucose tolerance administrated with pioglitazone（45 mg/d） were enrolled.Insulin sensitivity was assessed by the quantitative insulin sensitivity check index（QUICKI）,Endothelium-dependent vasodilation（flow-mediated vasodilation,FMD） and endothelium-independent vasodilations（nitroglycerin-induced vasodilation,NID） were measured in the brachial artery by high resolution ultrasound technique.Malondialdehyde（MDA） and reduced glutathione（GSH） were evaluated before and after experiment.Results： The levels of FMD,QUICKI and MDA were increased compared with the baselines.Conclusion： Pioglitazone treatment improves endothelial vasodilator function in patients with metabolic syndrome via enhancing insulin sensitivity and inhibition of oxidative stress.