罗格列酮对2型糖尿病合并冠心病患者胰岛素抵抗、静息和运动血压的影响

Effects of Rosiglitazone on Insulin Resistance, Resting and Exercise Blood Pressure in Type 2 Diabetes Mellitus Patients with Coronary Artery Heart Disease

目的:探讨罗格列酮对2型糖尿病(T2DM)合并冠心病(CHD)患者胰岛素抵抗、静息和运动血压的影响。方法:纳入2021年11月至2022年10月该院收治的T2DM合并CHD患者258例,根据随机数字表法分为罗格列酮组与对照组,每组129例。所有患者均给予抗血小板聚集、控制血糖和调节血脂等常规治疗;罗格列酮组患者加用罗格列酮片口服治疗,1次4 mg,1日1次。所有患者均连续治疗12个月。比较治疗前后罗格列酮组与对照组患者人体测量指标、生化指标、静息和运动血压及运动性高血压发病率。结果:治疗后,罗格列酮组患者体重(t=3.339,P<0.001)、体重指数(t=3.093,P=0.002)和皮下脂肪组织(t=5.086,P<0.001)较对照组显著升高;治疗后,罗格列酮组患者脂联素(t=15.135,P<0.001)较对照组显著升高,糖化血红蛋白(t=4.305,P<0.001)、空腹血糖(t=5.190,P<0.001)和胰岛素抵抗指数(t=6.815,P<0.001)较对照组显著降低;治疗后,罗格列酮组患者静息、运动中3 min、运动峰值、运动后1 min、运动后3 min及运动后5 min的收缩压和舒张压均较对照组显著降低(P<0.05),上述差异均有统计学意义。治疗后,罗格列酮组患者运动性高血压发病率较对照组显著降低[11.6%(15/129)vs.29.5%(38/129)],差异有统计学意义(χ^(2)=12.562,P<0.001)。结论:罗格列酮能够显著改善T2DM合并CHD患者的胰岛素抵抗、静息和运动血压,降低运动性高血压发病率,提高运动能力。

OBJECTIVE:To evaluate the effects of rosiglitazone,a peroxisome proliferator-activated receptor(PPAR)-γagonist,on insulin resistance,resting and exercise blood pressure in patients with type 2 diabetes mellitus(T2DM)complicated with coronary artery heart disease(CHD).coronary artery disease(CAD)METHODS:Totally 258 patients with T2DM complicated with CHD admitted into the First Affiliated Hospital of Xi’an Jiaotong University from Nov.2021 to Oct.2022 were extracted to be randomly divided into the rosiglitazone group and control group via the random number table method,with 129 cases in each group.All patients were given routine treatments such as antiplatelet aggregation,blood sugar control,and blood lipid regulation.The rosiglitazone group was additionally treated with oral Rosiglitazone tablets at a dose of 4 mg/time,once a day.All patients were treated continuously for 12 months.The anthropometric indicators,biochemical indicators,resting and exercise blood pressure,and the incidence rate of exercise-induced hypertension were compared between the rosiglitazone group and control group before and after treatment.RESULTS:After treatment,the body weight(t=3.339,P<0.001),body mass index(t=3.093,P=0.002)and subcutaneous adipose tissue(t=5.086,P<0.001)of the rosiglitazone group increased significantly compared with the control group;after treatment,the adiponectin(t=15.135,P<0.001)in the rosiglitazone group increased significantly compared with the control group,while the glycosylated hemoglobin(t=4.305,P<0.001),fasting blood glucose(t=5.190,P<0.001),and homeostatic model assessment of insulin resistance indicator(t=6.815,P<0.001)decreased significantly compared with the control group;after treatment,the systolic and diastolic blood pressure of the rosiglitazone group decreased significantly compared with the control group at rest,3 minutes during exercise,peak exercise,1 minute after exercise,3 minutes after exercise,and 5 minutes after exercise(P<0.05),with statistically significant differences.After treatment,the incidence of exercise-induced hypertension in the rosiglitazone group was significantly lower than that in the control group,with statistically significant differences[11.6%(15/129)vs.29.5%(38/129),χ^(2)=12.562,P<0.001].CONCLUSIONS:Rosiglitazone can significantly improve insulin resistance,resting and exercise blood pressure in T2DM patients with CHD,reduce the incidence of exercise-induced hypertension,and improve the exercise ability of patients.