吡格列酮对2型糖尿病患者血浆内皮素水平的影响

Effects of pioglitazone on plasma endothelin levels in patients with type 2 diabetes

目的 :评估胰岛素增敏剂吡格列酮对 2型糖尿病 (T2 DM)患者血浆内皮素 (ET)水平的影响。方法 :4 8名伴有轻度血管并发症的 T2 DM患者 ,随机、双盲分成吡格列酮组 (A组 2 4例 )、安慰剂组 (B组 2 4例 ) ,2 0名健康者作为对照组 (C组 ) ,采用放免法测定予吡格列酮治疗 3个月前后空腹血浆 ET及血清胰岛素水平 (FIns)。 结果 :(1)治疗前 A、B两组的空腹血浆 ET水平均明显高于 C组 (P<0 .0 1) ;(2 ) A、B两组的空腹血浆 ET水平与胰岛素成正相关 (r A=0 .6 35 1,r B=0 .6 4 87,P<0 .0 1) ;(3)治疗后 A组空腹血浆 ET、FIns、空腹血糖 (FBG)、糖化血红蛋白 (Hb A1 c)、甘油三酯 (TG)均有降低 (P<0 .0 1)。 (4) A、B两组不良反应的发生例数均为 8例。结论 :(1)伴有轻度血管并发症 T2 DM患者空腹血浆 ET水平升高 ;(2 )吡格列酮可降低 T2 DM患者空腹血浆 ET水平 ,有益于改善糖尿病血管并发症 ;(3)吡格列酮是治疗

Objective:To evaluate the effects of pioglitazone,a insulin sensitizing agent, on plasma endothelin levels in patients with type 2 diabetes. Methods:Type 2 diabetic patients( n =48) with moderate vascular complication, who were orally taking hypoglycemic agents:sulfonylurea and biguanides (metformin), were divided into pioglitazone group (group A, n =24) and placebo group (group B, n =24) by the rule of random and double blind. Healthy voluneers were taken as control(group C, n =20). Three months before and after treatment, fasting plasma endothelin levels and serum insulin levels were assayed by RIA. Results:(1) Before treatment, fasting plasma endothelin levels were higher in type 2 diabetic patients compared to control group( P <0.01). (2) A significant positive correlation between fasting plasma endothelin levels and fasting serum insulin levels ( r A=0.635 1, r B=0.648 7,respectively, all P <0.01) was noted in type 2 diabetic patients. (3) After treatment, fasting plasma endothelin levels, serum insulin levels, fasting blood glucose (FBG),hemoglobinA1c (HbA 1c ) and fasting triglyceride (TG) decreased in group A( P <0.01). (4)The case of adverse effects in pioglitazone group and in placebo was 8. Conclusion: (1) The fasting plasma endothelin levels are elevated in type 2 diabetic patients with moderate vascular complications. (2) Pioglitazone may reduce fasting plasma endothelin levels in type 2 diabetic patients and improve vascular complications of type 2 diabetic patients. (3) Pioglitazone is an effective and safe insulin sensitizing agent in patients with type 2 diabetes.