Gegick Charles G, Altheimer Michael D
Greensboro Endocrinology and Diabetes, Greensboro, NC, USA.
Curr Med Res Opin. 2004 Jun;20(6):919-30. doi: 10.1185/030079904125003908.
To compare the long-term effects on HbA(1c), lipid parameters, body weight, and hepatotoxicity after switching type 2 diabetes patients from troglitazone to either pioglitazone or rosiglitazone.
Of 125 study candidates from a previous prospective study, 100 patients (51 pioglitazone, 49 rosiglitazone) met criteria for comparing HbA(1c), lipids, body weight, and incidence of hepatotoxicity over 2 successive observation periods (3.1 and 12.6 months).
Mean absolute HbA(1c) decreased significantly, 0.53 and 0.27% in the pioglitazone and rosiglitazone groups, respectively, at the 12.6-month observation. Mean triglyceride (TG) decreased in the pioglitazone group at each interval with a cumulative decrease of 26.4% from baseline. In contrast, TG increased in the rosiglitazone patients by 43.3% at 3.1 months and then decreased (but remained above baseline) at 12.6 months. Mean high density lipoprotein (HDL) increased 22.1% with pioglitazone and 13.3% with rosiglitazone. In patients who had a baseline HDL < 35 mg/dL (0.91 mmol/L), pioglitazone treated patients experienced a significant increase at each interval resulting in a 52.6% increase in HDL compared to a 26.9% increase for rosiglitazone patients. Patients in both treatment groups had similar weight increases at each interval and no hepatotoxicity was noted.
With pioglitazone or rosiglitazone, changes in glycemic control, lipid effects, and body weight appear to continue over time. Pioglitazone treatment resulted in decreased triglyceride levels, while rosiglitazone was associated with an increase in triglyceride levels. HDL increased in both treatment groups, but in patients with a baseline HDL < 35 mg/dL (0.91 mmol/L), pioglitazone improved the HDL to a greater extent than rosiglitazone.
比较2型糖尿病患者从曲格列酮转换为吡格列酮或罗格列酮后对糖化血红蛋白（HbA1c）、血脂参数、体重及肝毒性的长期影响。
在之前一项前瞻性研究的125名研究对象中，100名患者（51名使用吡格列酮，49名使用罗格列酮）符合在连续两个观察期（3.1个月和12.6个月）内比较糖化血红蛋白、血脂、体重及肝毒性发生率的标准。
在12.6个月观察期时，吡格列酮组和罗格列酮组的平均绝对糖化血红蛋白分别显著下降0.53%和0.27%。吡格列酮组的平均甘油三酯（TG）在每个时间段均下降，从基线累计下降26.4%。相比之下，罗格列酮组患者的甘油三酯在3.1个月时升高43.3%，然后在12.6个月时下降（但仍高于基线）。平均高密度脂蛋白（HDL）在吡格列酮组升高22.1%，在罗格列酮组升高13.3%。在基线高密度脂蛋白<35mg/dL（0.91mmol/L）的患者中，吡格列酮治疗的患者在每个时间段均显著升高，高密度脂蛋白升高52.6%，而罗格列酮组患者升高26.9%。两个治疗组的患者在每个时间段体重增加相似，未观察到肝毒性。
使用吡格列酮或罗格列酮时，血糖控制、血脂影响及体重变化似乎会随时间持续存在。吡格列酮治疗导致甘油三酯水平下降，而罗格列酮与甘油三酯水平升高有关。两个治疗组的高密度脂蛋白均升高，但在基线高密度脂蛋白<35mg/dL（0.91mmol/L）的患者中，吡格列酮改善高密度脂蛋白的程度大于罗格列酮。
