Mita Tomoya, Watada Hirotaka, Ogihara Takeshi, Nomiyama Takashi, Ogawa Osamu, Kinoshita Junichiro, Shimizu Tomoaki, Hirose Takahisa, Tanaka Yasushi, Kawamori Ryuzo
Department of Medicine, Metabolism and Endocrinology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
Atherosclerosis. 2007 Mar;191(1):162-7. doi: 10.1016/j.atherosclerosis.2006.03.005. Epub 2006 Apr 17.
To investigate the effect of highly purified eicosapentaenoic acid (EPA) on the progression of diabetic macroangiopathy, we performed an open-label randomized prospective trial. A total of 81 Japanese type 2 diabetes were randomly assigned to the EPA (1800 mg/day) treated group or the control group. Carotid intima-media thickness (IMT) and brachial-ankle pulse wave velocity (baPWV) were evaluated before and after treatment in both groups. Sixty patients (EPA group, n=30; control group, n=30) completed this study. During the study period of 2.1+/-0.2 years, the mean IMT and max IMT of the EPA treated group showed a significant annual decrease compared with that of the control group (mean IMT, -0.029+/-0.112 mm versus 0.016+/-0.109 mm, respectively, P=0.029; max IMT, -0.084+/-0.113 mm versus -0.005+/-0.108 mm, respectively, P=0.0008). The baPWV was also improved significantly in the EPA treated group compared with the control group (-22.1+/-127.9 cm/s versus 62.3+/-223 cm/s, respectively, P=0.021). Multiple regression analysis showed that the administration of EPA was a significant and independent factor associated with an annual improvement of mean IMT (R2=0.067). In summary, this is the first demonstration that administration of purified EPA improves the carotid IMT and the baPWV in patients with type 2 diabetes.
为研究高纯度二十碳五烯酸(EPA)对糖尿病大血管病变进展的影响,我们进行了一项开放标签随机前瞻性试验。总共81例日本2型糖尿病患者被随机分配至EPA(1800毫克/天)治疗组或对照组。两组均在治疗前后评估颈动脉内膜中层厚度(IMT)和臂踝脉搏波速度(baPWV)。60例患者(EPA组,n = 30;对照组,n = 30)完成了本研究。在2.1±0.2年的研究期间,EPA治疗组的平均IMT和最大IMT与对照组相比每年均显著降低(平均IMT分别为-0.029±0.112毫米和0.016±0.109毫米,P = 0.029;最大IMT分别为-0.084±0.113毫米和-0.005±0.108毫米,P = 0.0008)。与对照组相比,EPA治疗组的baPWV也有显著改善(分别为-22.1±127.9厘米/秒和62.3±223厘米/秒,P = 0.021)。多元回归分析显示,EPA给药是与平均IMT年度改善相关的显著且独立因素(R2 = 0.067)。总之,这是首次证明纯化EPA给药可改善2型糖尿病患者的颈动脉IMT和baPWV。