吡格列酮对糖耐量减低并高胰岛素血症患者血浆同型半胱氨酸、内皮素的影响

目的 观察吡格列酮对合并高胰岛素血症的糖耐量减低（IGT）患者血浆同型半胱氨酸（Hcy）、内皮素（ET）的影响。方法 将60例IGT并高胰岛素血症患者随机分为吡格列酮组和安慰剂组,各30例,分别予盐酸吡格列酮及安慰剂干预治疗15周,测体重指数（BMI）、空腹血糖（FBG）及负荷后血糖（2 h PG）、胰岛素（Ins）、糖化血红蛋白（HbA1c）、胰岛素敏感性指数（ISI）、Hcy、ET等。结果 治疗前后比较,安慰剂组差异无统计学意义（P〉0.05）;吡格列酮组FBG、2 h PG、HbA1c、空腹胰岛素（FIns）、负荷后2 h胰岛素（2 h Ins）、Hcy、ET水平较治疗前显著下降,ISI显著上升（P〈0.05或P〈0.01）,两组治疗后比较差异有统计学意义（P〈0.05）。结论 吡格列酮在增加胰岛素敏感性同时可降低血浆Hcy、ET水平,保护血管内皮功能。

Effect of Pioglitazone on homocystein and endothelin levels in patients with impaired glucose tolerance combined with hyperinsulinemia

Objective To observe effect of Pioglitazone on plasma homocystein （Hey） and endothelin （ET） levels in pa- tients with impaired glucose tolerance （IGT） combined with hyperinsulinemia. Methods 60 IGT patients were divided into two groups randomly： Pioglitazone group （30 cases） and placebo group （30 cases）. Placebo were given to placebo group, while Pioglitazone were given to Pioglitazone group for 15 weeks. The body mass index （BMI）, fasting and post- prandial plasma glucose （PG）, insulin （Ins）, hemoglobin Alc （HbA lc）, insulin sensitivity index （ISI）, plasma Hcy and ET were observed. Results Indexes of placebo group showed no difference between before and after treatment （P 〉 0.05）. The levels of the fasting and postprandial PG and Ins, HbAlc, Hcy and ET dropped obviously in Pioglitazone group com- pared to both the baseline levels and the levels of placebo group at 15 weeks of treatment, the ISI increased markedly in Pioglitazone group （P 〈 0.05 or P 〈 0.01）, and showed statistical difference between the two groups （P 〈 0.05）. Conclusion Pioglitazone can improve insulin secretion and decrease the levels of Hcy and ET, protect the vascular en- dothelial function.