非诺贝特与吡格列酮对压力超负荷大鼠心肌细胞凋亡的影响

目的: 探讨过氧化物酶体增殖物激活型受体α和γ(PPARα和PPARγ)配体非诺贝特、吡格列酮对大鼠压力超负荷左心室肥厚过程中心肌细胞凋亡的调控作用,并观察其对凋亡相关基因Fas/Fas L表达变化的影响.方法: 雄性Wistar大鼠腹主动脉缩窄复制压力超负荷模型,术后48h存活的40只随机分成手术组(CAA组)、非诺贝特组[F组,30 mg/(kg·d)]、吡格列酮组[P组,3 mg/(kg·d)]及非诺贝特和吡格列酮合用组[F P组,非诺贝特30 mg/(kg·d),吡格列酮3 mg/(kg·d)].以假手术组(SH组)为对照,在给药处理8周后观察心肌超微结构、血流动力学参数、心室重塑指标、心肌细胞凋亡指数(CAI)及凋亡相关基因Fas/FasL蛋白表达的变化.结果: 压力超负荷大鼠心肌细胞出现凋亡的特征超微结构变化;F组、P组及F P组的左室湿重/体重、平均动脉压、左室收缩压、左室舒张末期压、心率、CAI及Fas/ FasL蛋白的表达低于CAA组,而左室压力上升、下降最大速率高于CAA组;上述指标在F组、P组及F P组间差异无统计学意义.结论: PPARα和γ信号通路激活能抑制压力超负荷大鼠的心肌肥厚和心肌细胞凋亡,改善血流动力学;PPARα、PPARγ配体合用无叠加效应.     

吡格列酮和罗格列酮治疗老年2型糖尿病的疗效对比(英文)

目的 探讨吡格列酮和罗格列酮对2型糖尿病患者血糖、血脂水平的影响.方法 将我院内分泌科门诊及病房收治的符合1997年WHO诊断标准的2型糖尿病患者64例.予以饮食控制,运动治疗,且同时口服降糖药物固定在1mo以上,空腹血糖仍≥7 mmol·L-1的患者,随机分为吡格列酮组和罗格列酮组,分别加用吡格列酮或罗格列酮12 wk.结果 ①吡格列酮组和罗格列酮组的空腹血糖、餐后2 h血糖、糖化血红蛋白、胰岛素抵抗指数均较治疗前明显降低(P＜0.05),两者之间降低的程度没有显著性差异.②毗格列酮组血三酰甘油和总胆固醇水平较治疗前明显降低(P＜0.05),但罗格列酮组无明显变化(P＞0.05).③2组的高密度脂蛋白水平均比治疗前明显升高(P＜0.05和P＜0.01),但吡格列酮组升高的幅度大于罗格列酮组.结论 吡格列酮和罗格列酮治疗后均能有效控制血糖,但吡格列酮能更明显地改善血脂.     

Effects of pioglitazone on proliferation and differentiation of human preadipocytes

Objective: To explore the effects of thiazolidinediones (TZDs) pioglitazone on proliferation and differentiation of human preadipocytes. Methods :Omental adipose tissue biopsies were obtained from 15 patients who were undergoing elective open-abdominal surgery. The primary culture and differentiated induction of human preadipocytes were performed, and the human preadipo-cytes were treated with pioglitazone at different concentrations at proper moments. Dynamic morphological changes of the human preadipocytes were observed, and their proliferation and differentiation were assessed with Colorimetric MTT Assay and Oil Red O Staining. Results:After 24 hours and 72 hours with pioglitazone, 0.1 μmol/L (μmol/ml) pioglitazone increased the MTT values of the human preadipocytes by 25.3% and 34.8% ,respectively(P ＜ 0.05), while 1 μ mol/L pioglitazone by 27.4% and 26.6%(P＜ 0.05), compared with the control group without pioglitazone. The human preadipocytes with pioglitazone cumulated more adipose in the endochylema than those without pioglitazone obviously. 0.1 μmol/L pioglitazone increased the differentiation degree of the human preadipocytes differentiated for 8-10 days by 44.81% and 1 μmol/L pioglitazone by 53.76%(P ＜ 0.05). Conclusion:Thiazolidinediones pioglitazone may significantly promote the proliferation and differentiation of the human omental preadipocytes.     

Combinations of ezetimibe with nonstatin drug regimens affecting lipid metabolism

In this article we discuss the available data on the effects of combined therapy of ezetimibe with agents affecting lipid metabolism other than statins. We consider studies evaluating the effects of combined therapy of ezetimibe with bile acid sequestrants, fenofibrate, niacin, n-3 fatty acids, plant sterols, orlistat, metformin, acarbose and glitazones. Combination of ezetimibe with bile acid sequestrants (especially colesevelam) was shown to have additional effects on lipid parameters in patients with hyperlipidemia. Combination of ezetimibe with fenofibrate may be a good approach to improve the overall lipid profile of patients with mixed hyperlipidemia. The addition of ezetimibe to niacin-based therapy can be useful for high-risk patients with dyslipidemia who are not achieving their assigned treatment goals. For patients who cannot tolerate statins there are useful combinations of ezetimibe with other drugs affecting lipid metabolism. These combinations improve many metabolic parameters, but more trials should be carried out to reach more robust conclusions about their effects on cardiovascular disease prevention.     

A long‐term comparison of pioglitazone and gliclazide in patients with Type 2 diabetes mellitus: a randomized,double‐blind,parallel‐group comparison trial

Aims This study compared the effects of pioglitazone and gliclazide on metabolic control in drug‐naïve patients with Type 2 diabetes mellitus. Methods A total of 1270 patients with Type 2 diabetes were randomized in a parallel‐group, double‐dummy, double‐blind study. Patients with poorly controlled Type 2 diabetes (HbA_1c 7.5–11%), despite dietary advice, received either pioglitazone up to 45 mg once daily or gliclazide up to 160 mg two times daily. Primary efficacy endpoint was change in HbA_1c from baseline to the end of the study. Secondary efficacy endpoints included change in fasting plasma glucose, fasting plasma insulin and plasma lipids. At selected centres, oral glucose tolerance tests were performed and C‐peptide and pro‐insulin levels were measured. Results Mean HbA_1c values decreased by the same amount in the two treatment groups from baseline to week 52 [pioglitazone: ?1.4%; gliclazide: ?1.4%; (90% CI: ?0.18 to 0.02)]. A significantly greater mean reduction in fasting plasma glucose was observed in the pioglitazone group (2.4 mmol/l) than in the gliclazide group [2.0 mmol/l; treatment difference ?0.4 mmol/l in favour of pioglitazone; P = 0.002; (95% CI: ?0.7 to ?0.1)]. Improvements in high‐density lipoprotein cholesterol (HDL‐C) and total cholesterol/HDL‐C were greater with pioglitazone than with gliclazide (P < 0.001). The frequencies of adverse events were comparable between the two treatment groups, but more hypoglycaemic events were reported for gliclazide, whereas twice as many patients reported oedema with pioglitazone than with gliclazide. Conclusions Pioglitazone monotherapy was equivalent to gliclazide in reducing HbA_1c, with specific differences between treatments in terms of mechanism of action, plasma lipids and adverse events.     

吡格列酮对人脐静脉内皮细胞血凝素样氧化低密度脂蛋白受体1表达的影响

目的探讨氧化型低密度脂蛋白(ox-LDL)作用下,吡格列酮对人脐静脉内皮细胞(HUVECs)血凝素样氧化低密度脂蛋白受体1(LOX-1)表达的影响。方法将培养的第4代HUVECs分5组:空白组(无干预);ox-LDL组(80 mg/L ox-LDL);低浓度组(1μmol/L吡格列酮+80 mg/L ox-LDL);高浓度组(10μmol/L吡格列酮+80 mg/Lox-LDL);对照组(10μmol/L吡格列酮),各组培养24 h后,采用流式细胞仪检测LOX-1的表达,采用RT-PCR检测LOX-1 mRNA的表达。结果与空白组比较,对照组LOX-1及LOX-1 mRNA表达均无明显改变(P0.05),ox-LDL组、低浓度组和高浓度组LOX-1及LOX-1 mRNA表达明显增多(P0.01);与ox-LDL组比较,低浓度组和高浓度组LOX-1及LOX-1 mRNA表达明显降低(P0.01);高浓度组较低浓度组降低更明显(P0.05)。结论吡格列酮能降低ox-LDL刺激下的HUVECs LOX-1及LOX-1 mRNA的表达,提示吡格列酮可能通过干预ox-LDL的病理生理过程起到抗动脉硬化的作用。     

吡格列酮对糖尿病大鼠血清MMP-9水平及其外周血单核细胞中MMP-9表达的影响

目的:观察过氧化物酶体增殖物激活受体γ(PPARγ)配体吡格列酮对糖尿病大鼠血清基质金属蛋白酶9(MMP-9)浓度和外周血单核细胞中MMP-9表达的影响。方法:40只Wistar大鼠随机分为5组,即对照组、糖尿病组和不同剂量5、10、20mg/(kg.d)吡格列酮治疗组,每组8只。给糖尿病组和3个吡格列酮治疗组大鼠腹腔注射链脲霉素制作糖尿病大鼠模型后,各吡格列酮治疗组以不同剂量的吡格列酮灌胃:5、10、20mg/(kg.d),共28d;对照组和糖尿病组以等量生理盐水灌胃。比较治疗前、后的血清MMP-9浓度的变化。分离大鼠外周血单核细胞,用RT-PCR和Westernblot检测MMP-9表达的变化。结果:与对照组比较,吡格列酮降低血清MMP-9的浓度(P0.05),降低外周血单核细胞中MMP-9的表达。结论:吡格列酮可以降低糖尿病大鼠血清MMP-9浓度及外周血单核细胞中MMP-9的表达,提示其在降糖之外还具有心血管保护作用。     

Rosiglitazone and pioglitazone increase fracture risk in women and men with type 2 diabetes

Aim: The objectives of the study were to determine whether thiazolidinedione (TZD) use is associated with an increased risk of fracture in men and women with type 2 diabetes mellitus and to compare the effects of pioglitazone and rosiglitazone. Materials and Methods: A research database of integrated pharmacy and medical claims was analysed using Cox models adjusted for age, gender, chronic obstructive pulmonary disease, asthma, osteoporosis, stroke, prior fracture and chronic disease score. Patients were followed for 540 days. Results: There was a 39% higher [adjusted hazard ratio (HR), 1.39; 95% confidence interval (CI), 1.32–1.46] incidence of fractures in men and women exposed to a TZD (n = 69047; age = 56 ± 5 years; 59% men; 48% rosiglitazone) compared with that in control patients (n = 75352; age = 56 ± 5 years; 51% men). Men treated with a TZD had a higher likelihood of fracture than control patients (adjusted HR rosiglitazone, 1.47; 95% CI, 1.38–1.56; adjusted HR pioglitazone, 1.43; 95% CI, 1.34–1.52). The HRs associated with pioglitazone (adjusted HR, 1.43; 95% CI, 1.34–1.52) and rosiglitazone (adjusted HR, 1.47; 95% CI, 1.38–1.56) were almost identical. TZD use was associated with a higher fracture risk in women aged above and below 50 years and in men aged above 50 years. Conclusions: Our findings add support to the growing literature that TZD treatment is associated with an increased risk of fractures in both men and women, that effects of rosiglitazone and pioglitazone are similar and that fracture risk is increased even in younger women.     

过氧化物酶体增殖物激活受体γ激动剂吡格列酮对大鼠创伤性脑损伤的影响

目的 观察PPARγ激动剂吡格列酮对大鼠创伤性脑损伤的神经保护作用.方法 将72只SD大鼠按随机数字表法分为假致伤组、对照组、吡格列酮治疗组,每组24只.采用改良的Feeney法制作脑创伤模型,治疗组采用吡格列酮(10 mg/kg)灌胃,假致伤组和对照组用等量生理盐水灌胃.致伤后在相应时相点行大鼠神经功能评分后,用干湿质量法进行脑组织含水量测定,进行HE、Nissl及TUNEL染色观察脑组织损伤、迟发性神经元死亡及神经细胞凋亡程度.结果 ①在伤后48 h、5 d,治疗组的神经功能评分[分别为(2.12±0.58)、(1.67±0.78)]好于对照组[(2.67±0.65)、(2.25±0.62),P<0.05];②伤后24 h治疗组与对照组脑组织含水量差异无统计学意义[分别为(78.84±1.92)%、(79.21±2.20)%,P>0.05];③伤后48 h,治疗组迟发性神经元死亡(38.59±1.97)%和神经细胞凋亡数(31.67±4.76)明显低于对照组[分别为(51.25±4.01)%、(45.33±4.68),P<0.05].结论 PPARγ激动剂吡格列酮能抑制创伤性脑损伤后的神经细胞凋亡,保护神经元,从而发挥神经保护作用.     

PPARγ agonist pioglitazone reverses memory impairment and biochemical changes in a mouse model of type 2 diabetes

OBJECTIVE Pioglitazone,known as a peroxisome proliferator-activated receptor γ(PPARγ) agonist,is used to treat type 2 diabetes(T2DM).T2DM has been associated with reduced performance on numerous domains of cognitive function.Here,we investigated the effects of pioglitazone on memory impairment in a mouse model with defects in insulin sensitivity and secretion,namely high-fat diet(HFD) streptozotocin(STZ)-induced diabetic mice.METHODS ICR mice were fed an HFD for 4 weeks and then injected with a single low dose of STZ followed by continued HFD feeding for an additional 4 weeks.The diabetic mice were orally administered with pioglitazone(9,18 mg·kg-1) for 4-5 weeks.Y-maze test and Morris water maze test(MWM) were employed for testing learning and memory.Serum glucose,serum insulin,serum triglyceride,brain amyloid peptide-β(Aβ),brain β-site amyloid precursor protein cleaving enzyme(BACE1),brain nuclear factor κB(NF-κB),brain receptor for advanced glycation end products(RAGE) were also tested.RESULTS The STZ/HFD diabetic mice,characterized by hyperglycemia,hyperlipemia and hypoinsulinemia,performed poorly on Y-maze and MWM hence reflecting impairment of learning and memory behavior with increases of Aβ40/Aβ42,BACE1,NF-κB,and RAGE in brain.Treatment of PPARγ agonist,pioglitazone,significantly reversed diabetes-induced impairment of learning and memory behavior,which is involved in decreases of Aβ40/Aβ42 via inhibition of NF-κB,BACE1 and RAGE in brain as well as attenuation of hyperglycemia,hyperlipemia and hypoinsulinemia.CONCLUSION It is concluded that PPARγ agonist pioglitazone may be considered as potential pharmacological agents for the management of cognitive dysfunction in T2DM.