Boyle Patrick J, King Allen Bennett, Olansky Leann, Marchetti Albert, Lau Helen, Magar Raf, Martin John
Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, USA.
Clin Ther. 2002 Mar;24(3):378-96. doi: 10.1016/s0149-2918(02)85040-8.
The antihyperglycemic effects of pioglitazone hydrochloride and rosiglitazone maleate are well documented. The results of clinical trials and observational studies have suggested, however, that there are individual differences in the effects of these drugs on blood lipid levels.
The present study evaluated the effects of pioglitazone and rosiglitazone on blood lipid levels and glycemic control in patients with type 2 diabetes mellitus.
This was a retrospective review of randomly selected medical records from 605 primary care practices in the United States in which adults with type 2 diabetes received pioglitazone or rosiglitazone between August 1, 1999, and August 31, 2000. The outcome measures were mean changes in serum concentrations of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and glycosylated hemoglobin (HbA1c) values.
Treatment with pioglitazone was associated with a reduction in mean TG of 55.17 mg/dL, a reduction in TC of 8.45 mg/dL, an increase in HDL-C of 2.65 mg/dL, and a reduction in LDL-C of 5.05 mg/dL. Treatment with rosiglitazone was associated with a reduction in mean TG of 13.34 mg/dL, an increase in TC of 4.81 mg/dL, a reduction in HDL-C of 0.12 mg/dL, and an increase in LDL-C of 3.56 mg/dL. With the exception of HDL-C, the differences in mean changes in lipid parameters between treatment groups were statistically significant (P < 0.001, pioglitazone vs rosiglitazone). Reductions in HbA1c were statistically equivalent between treatments (1.04% pioglitazone, 1.18% rosiglitazone).
Treatment with pioglitazone was associated with greater beneficial effects on blood lipid levels than treatment with rosiglitazone, whereas glycemic control was equivalent between the 2 treatments.
盐酸吡格列酮和马来酸罗格列酮的降糖作用已得到充分证实。然而，临床试验和观察性研究结果表明，这些药物对血脂水平的影响存在个体差异。
本研究评估吡格列酮和罗格列酮对2型糖尿病患者血脂水平和血糖控制的影响。
这是一项对美国605家初级保健机构随机选取的病历进行的回顾性研究，研究对象为1999年8月1日至2000年8月31日期间接受吡格列酮或罗格列酮治疗的成年2型糖尿病患者。观察指标为甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）血清浓度的平均变化以及糖化血红蛋白（HbA1c）值。
吡格列酮治疗使平均TG降低55.17mg/dL，TC降低8.45mg/dL，HDL-C升高2.65mg/dL，LDL-C降低5.05mg/dL。罗格列酮治疗使平均TG降低13.34mg/dL，TC升高4.81mg/dL，HDL-C降低0.12mg/dL，LDL-C升高3.56mg/dL。除HDL-C外，治疗组间血脂参数平均变化的差异具有统计学意义（P<0.001，吡格列酮与罗格列酮相比）。两种治疗方法降低HbA1c的效果在统计学上相当（吡格列酮为1.04%，罗格列酮为1.18%）。
与罗格列酮治疗相比，吡格列酮治疗对血脂水平的有益影响更大，而两种治疗方法的血糖控制效果相当。
