吡格列酮对Ⅱ型糖尿病并发冠心病患者血清视黄醇结合蛋白4的影响

目的观察吡格列酮对Ⅱ型糖尿病并发冠心痛（T2DM）患者血清视黄醇结合蛋白4（RBP4）的影响，并探讨其可能机制。方法随机选取T2DM合并冠心病患者60例，正常对照组30例。分别检测血清RBP4、肿瘤坏死因子（TNF-α）、脂联素、空腹血糖（FPG）和胰岛素（Ins）、体重指数（BMI）、血压（BP）、总胆固醇（TC）、甘油三酯（TG）等指标，计算胰岛素敏感指数（ISI）和胰岛素抵抗指数（HOMA-IR）。再将60例T2DM并发冠心病患者分成吡格列酮治疗组28例和常规治疗组32例，吡格列酮治疗组用吡格列酮治疗8周，治疗前后均测定上述指标。结果①T2DM合并冠心病患者与对照组比较，血清RBP4水平增高（P〈0．01）；吡格列酮治疗组与常规治疗组比较，血清RBP4无差异（P〉0．05）。②应用吡格列酮治疗后，患者血清RBP4水平显著降低（P〈0．01），TNpa、胰岛素水平下降（P〈0．05），脂联素水平升高（P〈0．05），IR明显改善。结论吡格列酮能降低T2DM并发心血管病患者血清RBP4水平，改善IR。

Influence of pioglitazone on serum retinol binding protein 4 in patients with type 2 diabetes mellitus accompanied with CHD

Objective To observe the effect of pioglitazone on serum retinol binding protein 4 （RBP4）in patients with type 2 diabetes mellitus accompanied with CHD and tentatively explore the mechanism. Methods Sixty patients with type 2 diabetes mellitus accompanied with CHD were randomly allocated into two groups： pioglitazone treated group （n= 28） and normal treated group （n= 32）. 30 healthy controls were selected from a healthy population. Patients in pio- glitazone treated group receive pioglitazone for 8 weeks. RBP4, TNF-α, adiponectin, fasting plasma glucose （FPG）, ser- um insulin level, BMI, BP, Plasma triglyceride （TG） and total cholesterol （TC） were measured. Results Compared to healthy controls group, RBP4 increased in patients with type 2 diabetes mellitus accompanied with CHD （P〈0.01）. There was no difference in pioglitazone treated group and normal treated group. The concentration of serum RBP4, TNF- aand serum insulin level decreased （P〈0.01 or P〈0.05）. The concentration of serum adiponectin increased and IR was improved in pioglitazone treated group. Conclusion Pioglitazone can decrease the concentration of serum RBP4 and im- prove IR in patients with type 2 diabetes mellitus accompanied with CHD.