加倍剂量阿托伐他汀干预对2型糖尿病患者脂代谢、胰岛素抵抗及颈动脉粥样硬化的影响

Effect of doubling-dose atorvastatin intervention on lipid metabolism,insulin resistance and carotid atherosclerosis in patients with type 2 diabetes mellitus

目的:探讨加倍剂量阿托伐他汀干预对2型糖尿病患者脂代谢、胰岛素抵抗及颈动脉粥样硬化的影响。方法:收集在本院接受治疗的2型糖尿病患者118例,按照随机数表法分为接受单倍剂量阿托伐他汀(20mg/次,1次/d)治疗的单倍剂量组、接受加倍剂量阿托伐他汀(40 mg/次,1次/d)治疗的加倍剂量组各59例,均持续治疗3月。对比两组治疗前后血清中脂质代谢指标、胰岛素抵抗指标、颈动脉粥样硬化相关指标水平的差异。结果:治疗前,两组血清中脂质代谢指标、胰岛素抵抗指标、颈动脉粥样硬化相关指标水平的差异无统计学意义(P>0.05)。治疗后,观察组血清中脂质代谢指标TC、TG、FFA、LDL-C的含量低于对照组,HDL-C的含量高于对照组;血清中胰岛素抵抗指标INS、HOMA-IR的水平低于对照组,HOMA-β水平高于对照组;血清中颈动脉粥样硬化相关指标visfatin、OPG、CysC、HMGB1的含量低于对照组患者(P<0.05)。结论:加倍剂量阿托伐他汀可更为有效的降低2型糖尿病患者的高脂血症,减轻胰岛素抵抗及颈动脉粥样硬化。

Objective：To study the effect of doubling-dose atorvastatin intervention on lipid metabolism,insulin resistance and carotid atherosclerosis in patients with type 2diabetes mellitus.Methods：A total of 118 patients with type 2diabetes mellitus treated in our hospital between May 2013 and December 2016 were collected,random number table was used to divide them into the single dose group（n=59）who received single-dose atorvastatin（20mg/time,1times/d）therapy and the double dose group（n=59）who received doubling-dose atorvastatin（40mg/time,1times/d）therapy,and both therapies lasted for 3months.Serum levels of lipid metabolism indexes,insulin resistance indexes and carotid atherosclerosis-related indexes were compared between the two groups of patients before and after treatment.Results：Before treatment,differences in serum levels of lipid metabolism indexes,insulin resistance indexes and carotid atherosclerosis-related indexes were not statistically significant between two groups of patients（P〉0.05）.After treatment,serum lipid metabolism indexes TC,TG,FFA and LDL-C contents of observation group were lower than those of control group while HDL-C content was higher than that of control group;serum insulin resistance indexes INS and HOMA-IR levels were lower than those of control group while HOMA-βlevel was higher than that of control group;serum carotid atherosclerosis-related indexes visfatin,OPG,CysC and HMGB1 contents were lower than those of control group（P〈0.05）.Conclusions：Doubling-dose atorvastatin may be more effective in decreasing the hyperlipidemia and reducing the insulin resistance and carotid atherosclerosis in patients with type 2diabetes mellitus.