阿卡波糖对高血压前期伴发糖耐量减低患者血清脂联素与瘦素水平的影响  

Intervention effect of acarbose on adiponectin and leptin in patients with impaired glucose tolerance and prehypertension

作　　者：张在勇 汪征[2] 李自成[2] 郭军[2] 单光华[2] 

机构地区：[1]广州市番禺区中心医院心内科,广州514000 [2]暨南大学附属第一医院心内科

出　　处：《临床心血管病杂志》2013年第8期570-573,共4页Journal of Clinical Cardiology

基　　金：广东省自然基金资助项目(No:9151009101000016);CGICC医学科研支持计划专项资金项目(No:08010028)

摘　　要：目的:观察高血压前期伴发糖耐量减低患者血清脂联素、瘦素水平及阿卡波糖干预的影响。方法:入选高血压前期伴发糖耐量减低患者105例(研究组)及健康对照组28例。研究组服用阿卡波糖50mg/次、3次/d,进行为期12周的临床观察;测量两组初始及药物处理后血清脂联素与瘦素水平、血脂、空腹及餐后2h血糖(2hPG)、超敏CRP(hs-CRP)及BMI,并予相关性分析。结果:干预前,研究组较对照组脂联素值低[(6.324±2.871)μg/ml∶(7.438±3.514)μg/ml,P=0.039],而瘦素水平在两组间差异无统计学意义;Pearson相关分析提示,脂联素水平与平均动脉压、2hPG及hs-CRP呈负相关性(均P<0.05),瘦素水平与BMI、平均动脉压、空腹血糖、hs-CRP、2hPG呈正相关性(均P<0.05);研究组使用阿卡波糖干预3个月后,2hPG、胰岛素抵抗指数(HOMA-IR)、空腹血清胰岛素(FINS)与hs-CRP均较干预前明显降低,脂联素水平明显升高(均P<0.05)。结论:高血压前期伴发糖耐量减低患者血清脂联素与瘦素水平较正常人有差异,但只有脂联素差异有统计学意义,提示脂联素可作为此类人群早期评价胰岛素抵抗程度的新指标;阿卡波糖可降低餐后血糖,可能通过减少胰岛素抵抗及减轻炎症反应延缓高血压及糖耐量减低的病程进展。Objective：To observe the intervention effect of acarbose on adiponectin and leptin in patients with impaired glucose tolerance （IGT） and prehypertension. Method：One hundred and five patients with IGT and pre hypertension （intervention group） and 28 healthy people （control group） were selected. The patients in interven- tion group were treated with acarbose （50 rag/times, 3 times a day）. Serum adiponectin and leptin, lipids, fasting plasma glucose （FPG）, 2 h postprandial glucose （2 h PG）, high sensitivity C reactive protein （hs-CRP） and BMI were measured. Result：Before acarbose intervention, the level of adiponectin was lower in intervention group than that in control group ^（6. 324!2. 871）ttg/ml ： （7. 438_＋_3. 514）ttg/ml, P=0. 039], while there was no significant difference in leptin levels between the two groups. Pearson relation analysis showed that adiponectin concentration was negatively correlated with mean blood pressure （MBP）, hs-CRP and 2 h PG, the level of leptin was positively correlated with BMI, MBP, FPG＇, hs-CRP and 2 h PG. After 3 months of acarbose treatment, 2 h PPG, fasting insulin （FINS） and hs-CRP decreased significantly （all P〈 0.05）, and adiponectin increased significantly （P〈 0.05）. Conclusion： There are differences of adiponectin and leptin between IGT accompanying prehypertension patients and normal people, but only adiponectin has statistics significance. Adiponectin can be a new sensitive indicator for early evaluation of insulin resistance. Acarbose may reduce inflammation and decrease postprandial plasma glucose and insulin resistance, which delay the progression of hypertension and IGT.

关 键 词：高血压前期 阿卡波糖 糖耐量减低 脂联素 瘦素 

分 类 号：R544.1[医药卫生—心血管疾病]