Hirose Hiroshi, Kawai Toshihide, Yamamoto Yukihiro, Taniyama Matsuo, Tomita Motowo, Matsubara Koichi, Okazaki Yasunori, Ishii Tatsuya, Oguma Yuko, Takei Izumi, Saruta Takao
Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Metabolism. 2002 Mar;51(3):314-7. doi: 10.1053/meta.2002.30506.
The aim of this study was to evaluate the effects of pioglitazone on clinical and metabolic parameters, body fat distribution, and serum adiponectin, a recently discovered antiatherosclerotic hormone, in Japanese patients with type 2 diabetes. Ten male patients aged 40 to 66 (57.7 +/- 7.4) years, who were being treated with dietary therapy alone (n = 7) or with a stable dose of sulfonylurea (n = 3), were studied at baseline and after 3 months of pioglitazone treatment (30 mg/d). Body mass index (BMI), blood pressure, fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), serum insulin, adiponectin, and lipid profile were measured. Also, visceral adipose tissue area (VAT) and subcutaneous adipose tissue area (SAT) at the umbilical level were determined by computed tomographic (CT) scanning. Mean blood pressure (109 +/- 14 to 101 +/- 10 mm Hg), FPG (8.6 +/- 1.4 to 7.0 +/- 1.0 mmol/L), serum insulin (54 +/- 11 to 30 +/- 8 pmol/L, P <.01 for all), and HbA1c (6.7 +/- 0.8 to 6.1% +/- 0.6%, P =.013) decreased significantly during 3 months of pioglitazone treatment. BMI (26.4 +/- 3.2 to 27.0 +/- 3.5 kg/m2), low-density lipoprotein (LDL) cholesterol (124 +/- 24 to 138 +/- 24 mg/dL) and SAT (155 +/- 69 to 179 +/- 81cm2, P <.05 for all) increased, while triglycerides and high-density lipoprotein (HDL) cholesterol did not change significantly after 3 months of pioglitazone treatment. Serum adiponectin level increased in all patients (4.8 +/- 1.7 to 14.4 +/- 2.1 microg/mL, P =.005). VAT tended to increase (165 +/- 38 to 180 +/- 46 cm2) and VAT/SAT ratio tended to decrease (1.2 +/- 0.3 to 1.1 +/- 0.3), but these differences did not reach statistical significance. These results suggest that pioglitazone exerts good glycemic and blood pressure control despite increased BMI and SAT in Japanese male patients with type 2 diabetes. It is also suggested that pioglitazone may have an antiatherosclerotic effect by increasing serum adiponectin level.
本研究旨在评估吡格列酮对日本2型糖尿病患者临床和代谢参数、体脂分布以及血清脂联素（一种最近发现的抗动脉粥样硬化激素）的影响。对10名年龄在40至66（57.7±7.4）岁的男性患者进行了研究，这些患者单独接受饮食治疗（n = 7）或接受稳定剂量的磺脲类药物治疗（n = 3），在基线时以及吡格列酮治疗（30 mg/d）3个月后进行观察。测量了体重指数（BMI）、血压、空腹血糖（FPG）、糖化血红蛋白（HbA1c）、血清胰岛素、脂联素和血脂谱。此外，通过计算机断层扫描（CT）确定脐水平的内脏脂肪组织面积（VAT）和皮下脂肪组织面积（SAT）。在吡格列酮治疗3个月期间，平均血压（从109±14降至101±10 mmHg）、FPG（从8.6±1.4降至7.0±1.0 mmol/L）、血清胰岛素（从54±11降至30±8 pmol/L，所有P <.01）和HbA1c（从6.7±0.8降至6.1%±0.6%，P =.013）均显著下降。BMI（从26.4±3.2增至27.0±3.5 kg/m2）、低密度脂蛋白（LDL）胆固醇（从124±24增至138±24 mg/dL）和SAT（从155±69增至179±81cm2，所有P <.05）增加，而吡格列酮治疗3个月后甘油三酯和高密度脂蛋白（HDL）胆固醇无显著变化。所有患者的血清脂联素水平均升高（从4.8±1.7增至14.4±2.1 μg/mL，P =.005）。VAT有增加趋势（从165±38增至180±46 cm2），VAT/SAT比值有降低趋势（从1.2±0.3降至1.1±0.3），但这些差异未达到统计学意义。这些结果表明，尽管日本2型糖尿病男性患者的BMI和SAT增加，但吡格列酮仍能有效控制血糖和血压。还表明吡格列酮可能通过提高血清脂联素水平而具有抗动脉粥样硬化作用。
