中老年人餐后高甘油三酯血症的临床干预

目的了解噻唑烷二酮类药物马来酸罗格列酮对餐后高甘油三酯(TG)血症中老年患者的疗效。方法采用改良脂肪餐负荷试验,以餐后4 h血清TG水平(TG 4 h)>2 mmol/L确定为餐后高TG血症患者39例,随机分为非诺贝特组12例(口服微粒化非诺贝特200 mg,每晚1次顿服,共8周),罗格列酮组27例(口服马来酸罗格列酮4 mg,每天1次晨服,共8周),两组于治疗前、治疗后4周和8周进行脂肪餐负荷试验,同时测定空腹血糖(FPG)和空腹胰岛素(FIns),以胰岛素敏感指数(ISI)作为胰岛素敏感性判断指标,进行对比分析。结果在不同时段两组内脂肪餐负荷试验前后比较,TG4h水平较同组餐前空腹TG水平比较升高(P<0.05),而脂肪餐后HDL-C水平较同组餐前空腹HDL-C水平明显下降(P<0.05),TC、LDL-C均未见明显变化;非诺贝特组治疗8周后,空腹TG、TG4h均呈明显下降(P<0.05),HDL-C、餐后4h HDL-C呈明显升高(P<0.05);罗格列酮组治疗8周后,空腹TG、TG4h、ISI绝对值均呈明显下降(P<0.05),HDL-C、餐后4hHDL-C呈明显升高(P<0.05)。结论短期应用马来酸罗格列酮不仅可以改善胰岛素敏感性,还可以有效地降低餐后高TG血症患者的餐后TG水平,升高HDL-C水平。

The clinical intervention on postprandial hypertriglyceridemia in middle and elderly people

Objective To evaluate the clinical effect of the rosiglitazone(RSG) on the middle and elderly patients with postprandial hypertriglyceridemia.Methods Thirty-nine patients who had TG_(4h) more than 2 mmol/L were selected according to the improved fat diet burden test.The subjects were randomly divided into two groups,the group C(n=12)and RSG group(n=27).The former group were given microcapsule 200mg/day orally in the evening for 8 weeks,the later group were given 4mg/day orally in the morning for 8 weeks.The serum TG、TC、HDL-C and LDL-C were measured as a reference index,at same time,the FPG、FIns were measured.Insulin sensitivity index(ISI) calculated.The parameters above were measured again at the 4th week and the 8th week after treatment.Results The postprandial TG_(4h) levels were higher than that of the preprandial TG in the two groups at different periods(P<0.05),but the postprandial HDL-C reduced dramatically(P<0.05),the serum TC and LDL-C showed no change(P>0.05);In the group C,both fasting TG and TG_(4h) were reduced obviously 8 weeks after treatment(P(<0.05)),HDL-C and postprandial HDL-C 4 hours after fat diet were elevated obviously(P<0.05);In the RSG group,the absolute serum TG,TG_(4h) and ISI were reduced obviously(P<0.05),HDL-C and postprandial HDL-C 4 hours after fat diet were elevated obviously(P<(0.05)).Conclusion The short-term administration of rosiglitazone(RSG) can not only improve the insulin sensitivity,but reduce effectively the level of the postprandial serum TG and increase level of serum HDL-C.