吡格列酮对2型糖尿病患者血清脂联素与胰岛素抵抗的影响  

Effects of pioglitazone on serum adiponectin levels and insulin resistance in patients with type 2 diabetes mellitus

作　　者：代芳[1] 王长江[1] 章秋[1] 贾敬华[1] 胡红琳[1] 何勇[1] 左春林[1] 

机构地区：[1]安徽医科大学第一附属医院内分泌科,安徽合肥230022

出　　处：《安徽医药》2009年第7期808-810,共3页Anhui Medical and Pharmaceutical Journal

基　　金：安徽省教育厅项目(NoKJ2009B047Z)

摘　　要：目的探讨吡格列酮对2型糖尿病患者血清脂联素水平及胰岛素抵抗的影响。方法2型糖尿病患者45例,两组年龄、性别匹配,按随机双盲法分为吡格列酮组(22例)和安慰剂组(23例),干预治疗12周后比较其血清脂联素、游离脂肪酸(FFA)水平,同时测血糖、血压、血脂、身高、体重、腰围、臀围,计算体重指数(BMI)、腰臀比值(WHR)、空腹胰岛素(Fins)和胰岛β细胞功能(HOMA-IR)。结果治疗前两组的脂联素、游离脂肪酸水平无明显差别,经吡格列酮治疗后,患者血糖、胰岛素抵抗明显改善(P<0.05),血清脂联素水平显著升高(P<0.05),血清FFA水平下降(P<0.05),血清脂联素升高与FFA下降无显著相关性(P>0.05)。结论吡格列酮除改善血糖及胰岛素抵抗外,还可使血清脂联素水平升高,FFA水平降低,提示吡格列酮可能通过降低FFA、升高脂联素水平改善2型糖尿病患者胰岛素抵抗。Aim To discuss the effects of pioglitazone on serum adiponeetin levels and insulin resistance in patients with type 2 diabetes mellitus. Methods Forty-five subjects with type 2 diabetes mellitus which were matched with age and gender were assigned to either pioglitazone group or placebo group according to randomized, double-blind method （22 and 23 subjects respectively）. Comparison of serum adiponectin ,free fatty acid levels at baseline and after 12 weeks, together the levels of blood glucose ,blood pressure, blood lipids, height, weight, waist circumference, hip circumference, body mass index （BMI）, waist-hip ratio （WHR） and insulin sensitivity index （ISI）, islet β-cell function （HOMA-IR） were evaluated. Results Compared with placebo group,there was no significant difference between serumadiponectin and serum free fatty acid levels before treatment. After 12 weeks＇treatment with pioglitazone, blood glucose and insulin resistance improved significantly （ P 〈 0.05 ）. Serum adiponectin levels significantly increased （ P 〈 0.05 ） , serum free fatty acid levels decreased（P 〈 0.05） ,which had no certain relevance. Conclusions In addition to improving blood glucose and insulin resistance, pioglitazone also can increase serum adiponectin levels, decrease serum free fatty acid levels. It is suggested that pioglitazone exerts its beneficial effects of improving IR in T2DM by increasing the levels of adiponectin and decreasing free fatty acid levels.

关 键 词：吡格列酮 脂联素 2型糖尿病 游离脂肪酸 

分 类 号：R587.1[医药卫生—内分泌] R977.15[医药卫生—内科学]