阿卡波糖对冠心病合并糖耐量受损患者 YKL-40和肠道菌群的影响

Effects of acarbose on YKL-40 and gut bacteria in coronary heart disease patients with impaired glucose tolerance

目的探讨阿卡波糖在冠心病合并糖耐量受损(IGT)患者中对于炎症因子YKL-40和肠道菌群的作用。方法选取冠心病合并IGT患者57例,随机分为对照组(A组,n=27)和阿卡波糖300 mg/d干预组(B组,n=30),分别在基线水平和24周实验结束时进行体质指标评估、空腹血糖(FBG)、餐后2 h血糖(PBG)、血清胰岛素(FINS),血脂、糖化血红蛋白(HbA1C)和血清YKL-40测定;应用实时荧光定量PCR检测粪便中双歧杆菌和乳酸菌的含量。结果 A组和B组基线资料差异无统计学意义(P>0.05),Pearson相关结果分析表明,双歧杆菌和乳酸菌水平与YKL-40呈负相关。24周研究终点时B组YKL-40、FBG、PBG、HbA1c、胰岛素抵抗指数HOMA-IR等指标较A组显著降低(P<0.05);粪便双歧杆菌和乳酸菌含量显著增加(P<0.05)。结论应用300 mg/d阿卡波糖治疗24周后,冠心病合并IGT患者血糖得到改善, YKL-40显著下降,肠道内有益细菌菌群数量增加。

Objective To investigate the effects of alpha-glucosidase inhibitor, acarbose, on YKL-40 and gut bacteria in coronary heart disease (CHD) patients with impaired glucose tolerance (IGT). Methods A total of 57 CHD patients with IGT were randomly divided into the control group (group A,n = 27) and 300 mg/d acarbose intervention group (group B,n = 30). At the baseline and 24-week end point, anthropometrical parameters, fast blood glucose (FBG), 2 h postprandial blood glucose (PBG), serum fast insulin (FINS), lipid profile, HbAlc and serum YKL-40 were measured. The quantification of fecal Bifidobacterium and Lactobacillus faecalis were detected with RT-PCR. Results There were no significant differences between the two groups in terms of the physical and hematological parameters at baseline. Pearson correlation analysis showed that levels of Bifidobacterium and Lactobacillus were negatively correlated with YKL-40. After 24-week acarbose (300 mg/d) treatment, the levels of YKL-40, FBG, PBG, HbAlc and HOMA-IR significantly decreased in group B (P<0.05), while the levels of Bifidobacterium and Lactobacillus significantly increased in group B (P<0.05). Conclusion After 24-week treatment with 300 mg/d acarbose, CHD patients with IGT have improved glucose metabolism, decreased YKL-40 level, but increased number of beneficial gut microbiota.