罗格列酮对糖调节受损患者红细胞变形能力及炎症因子的影响

Effects of rosiglitazone on red cell deformability and inflammatory cytokines in patients with impaired glucose regulation

目的观察噻唑烷二酮类药物罗格列酮对糖调节受损患者红细胞变形能力及部分炎症因子的影响,进一步探讨噻唑烷二酮类药物的降糖外作用及其发生机制。方法新诊断的糖调节受损患者80例随机分为生活方式组(n=40)和罗格列酮组(n=40)。生活方式组给予生活方式干预,罗格列酮组给予生活方式联合干预罗格列酮4 mg/d口服,疗程6个月。治疗前及治疗后第3,6个月测糖化血红蛋白(HbA1c)、血清高敏C反应蛋白(hsCRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、脂联素水平及红细胞刚性指数。结果治疗前2组HbA1c、hs-CRP、TNF-α、IL-6、脂联素、红细胞刚性指数均无显著性差异(P均>0.05);治疗后生活方式组TNF-α、IL-6、脂联素无显著变化(P均>0.05);3个月时2组HbA1c、hs-CRP、红细胞刚性指数及罗格列酮组TNF-α、IL-6显著下降(P均<0.05),6个月时罗格列酮组的脂联素水平显著升高(P<0.05),罗格列酮组HbA1c、红细胞刚性指数、hs-CRP、TNF-α、IL-6均显著低于生活方式组,脂联素水平显著高于生活方式组(P<0.01);6个月时罗格列酮组hs-CRP、TNF-α、IL-6、红细胞刚性指数与同组3个月时比较显著降低(P均<0.05),脂联素水平显著升高(P<0.05),红细胞刚性指数与hs-CRP呈显著正相关(r=0.832,P<0.05)。结论生活方式干预联合噻唑烷二酮类药物治疗糖调节受损,在降低血糖的同时,可以改善红细胞变形能力,抑制机体炎症反应,进一步改善胰岛功能,预防糖尿病及其并发症的发生。

Objective It is to observe the effects of thiazolidinedione drug rosiglitazone on red cell deformability and inflammatory cytokines in patients with impaired glucose regulation in order to explore its action except hypoglycemic action and mechanism.Methods 80 patients with impaired glucose regulation were randomly divided into group lifestyle （n =40） and group rosiglitazone（n =40）.Lifestyle interventions targeted the patients in group lifestyle for 6 months while lifestyle interventions combined with rosiglitazone（4 mg/d） in group rosiglitazone.HbA1C,hs-CRP,IL-6,TNF-α,adiponectin and erythrocyte rigidity index were measured before and 3,6months after treatment.Results Before the treatment,there was no significant difference between the two groups in HbA1C,hs-CRP,IL-6,TNF-α,adiponectin and erythrocyte rigidity index （P 〉 0.05）.After the treatment,IL-6,TNF-α and adiponectin were not improved in group lifestyle （P 〉 0.05）.HbA1c,hs-CRP and erythrocyte aggregation index in two group and TNF-α and IL-6 in group rosiglitazone were significantly reduced at the 3rd month while adiponectin in group rosiglitazone was significantly increased at the 6th month after treatment （P 〈0.01）.HbA1c,hs-CRP,TNF-α,IL-6 and erythrocyte rigidity index in group rosiglitazone were significantly lower and adiponectin higher than group lifestyle （P 〈 0.01） ; hs-CRP,TNF-α,IL-6 and erythrocyte rigidity index in group rosiglitazone at the 6th month were significantly lower and adiponectin higher than that at the 3rd after treatment （P 〈 0.05）.Erythrocyte rigidity index was positively correlated with hs-CRP （r =0.832,P 〈 0.05）.Conclusion Lifestyle interventions combined with the thiazolidinedione drug administration not only can reduce blood glucose,but also improve red cell deformability and inhibit the inflammatory response in patients with impaired glucose regulation in order to improve the function of islet and prevent the occurrence of diabetes and its complications.