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[降脂药物对老年2型糖尿病的代谢影响]

[Metabolic effects of hypolipemic drugs on aged type 2 diabetes].

作者信息

Palel G, Coman A, Petrovanu R, Ungureanu D

机构信息

Disiciplina Medicină de Familie-Adulţi, Facultatea de Medicină, Universitatea de Medicină şi Farmacie Gr. T. Popa Iaşi.

出版信息

Rev Med Chir Soc Med Nat Iasi. 2001 Jul-Sep;105(3):518-20.

Abstract

There are multiple lipids anomalies on diabetes. IDDM has, because of insulin lack, increased levels of triglycerides and afferent lipoproteins. NIDDM, especially obese one, linked by insulinoresistance and hyperinsulinemia, has different and complex anomalies by quality and quantity. There is a specific shape for this anomalies named "B phenotype" with high cardiovascular risk: rise LDL-chol charged with TG and low level of HDL-chol. We searched lipoproteins levels and the effects of simvastatin on aged persons (after 60 years). We randomised 158 cases with obese type II diabetes on a case control study. We concluded that only 28% had high TG levels and 71.8% had low levels of HDL-chol. For HDL-chol this percent is higher over 60 years old group (88.75%) (p < 0.001). Cholesterol has no significant high levels (28.55%) (p < 0.5), and aged group has almost normal levels of cholesterol and triglycerides (p < 0.0001). We administered simvastatin (Zocor) on 86% cases, therapeutically doses, during a period of 6 months to one year. Making lipidograms initially, after 6 months and a year, we proved good effects of Zocor, on lipoproteins levels: rise levels of HDL-chol (p < 0.005), moderate effect on LDL-chol (p < 0.01). At the same time the treatment improving the glucose tolerability to both groups (p < 0.002).

摘要

糖尿病存在多种脂质异常情况。由于胰岛素缺乏,胰岛素依赖型糖尿病(IDDM)患者的甘油三酯和传入脂蛋白水平升高。非胰岛素依赖型糖尿病(NIDDM),尤其是肥胖患者,因存在胰岛素抵抗和高胰岛素血症,在质量和数量上有不同且复杂的异常情况。这种异常情况有一种特定的形式,称为“B 型表型”,具有较高的心血管风险:富含甘油三酯的低密度脂蛋白胆固醇(LDL-chol)升高,高密度脂蛋白胆固醇(HDL-chol)水平降低。我们研究了脂蛋白水平以及辛伐他汀对老年人(60 岁以上)的影响。我们将 158 例肥胖 II 型糖尿病患者随机分组进行病例对照研究。我们得出结论,只有 28%的患者甘油三酯水平高,71.8%的患者高密度脂蛋白胆固醇水平低。对于高密度脂蛋白胆固醇,60 岁以上组的这一比例更高(88.75%)(p < 0.001)。胆固醇无显著高水平(28.55%)(p < 0.5),老年组的胆固醇和甘油三酯水平几乎正常(p < 0.0001)。我们对 86%的病例给予治疗剂量的辛伐他汀(舒降之),疗程为 6 个月至 1 年。在开始时、6 个月后和 1 年后进行血脂谱检测,我们证明舒降之对脂蛋白水平有良好效果:高密度脂蛋白胆固醇水平升高(p < 0.005),对低密度脂蛋白胆固醇有中度影响(p < 0.01)。同时,该治疗改善了两组患者的葡萄糖耐受性(p < 0.002)。

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