阿托伐他汀对2型糖尿病患者血清脂联素水平及颈动脉内膜中层厚度的影响

目的观察阿托伐他汀对2型糖尿病患者血清脂联素(APN)水平及颈动脉内膜中层厚度(IMT)的影响。方法2型糖尿病患者71例,均在生活方式干预的同时口服降糖药和(或)胰岛素强化治疗,均服用阿司匹林0.1g/d。治疗组在上述治疗基础上每晚加服阿托伐他汀20mg,对照组服用安慰剂,总疗程24周,观察治疗前后血清APN、超敏C反应蛋白(hsCRP)、白介素-6(IL-6)、IMT,并分析IMT与APN、hsCRP、IL-6的相关性。结果与治疗前相比,治疗组治疗后IMT、斑块检出率及hsCRP、IL-6的血清浓度均下降(P<0.05,P<0.01),血清APN浓度明显上升(P<0.01),对照组治疗前、后IMT、APN、hsCRP、IL-6的差异无统计学意义(P>0.05)。治疗前后2组IMT与APN均呈负相关(P<0.01),与hsCRP、IL-6均呈正相关(P<0.01)。结论阿托伐他汀能够升高2型糖尿病患者血清APN水平,降低IMT及血清hsCRP、IL-6,推测阿托伐他汀降低糖尿病患者IMT与改善血管内皮功能及抑制炎性反应有关。

The effects of atorvastatin on the level of serum adiponectin and carotid intima media thickness in type 2 diabetes mellitus

Objective To study the effects of atorvastatin on the level of serum adiponectin（APN） and carotid intima media thiekness（IMT） in type 2 diabetes mellitus （DM）.Methods 71 patients with type 2 DM were recruited in this randomized trial.Based on the intervention of life style,all patients undertook oral antidiabetie drug and/or insulin intensification therapy, and with aspirin 0.1 g/d. The treatment group was added atorvastafin 20 mg every night, while the control group was added the placebo. Course of treatment was 24 weeks. The level of APN, hsCRP, IL-6,IMT was detected before and after treatment, and the correlation between IMT and APN, hsCRP, IL-6 was analyzed. Results In the treatment group, the IMT decreased（ P 〈0.01） after atorvastafin therapy, the detection rate of plaque was degraded（ P 〈 0.05）,and the plasma concentration of APN was upgraded（ P 〈 0.01 ）, while the plasma concentration of hsCRP, IL-6 was even degraded （ P 〈 0.01 ） .In control group,the distinction of IMT,APN,hsCRP,IL-6 between before and after therapy had not statistical significant （ P 〉 0.05）.There was negative correlation between IMT and APN in both groups （ P 〈 0.01）,while the correlation between IMT and hsCRP, IL-6 showed positively （ P 〈 0.01 ）. Conclusion It demonstrated that atorvastatin could help to increase the plasma concentration of APN and decrease the IMT, hsCRP and IL-6 in patients with type 2 DM, probably it improved the function of endothelium and suppressing inflammatory reaction.