Tonutti L, Taboga C, Noacco C
Servizio di Diabetologia, Ospedale Civile, Udine.
Minerva Med. 1991 Oct;82(10):657-63.
Atherosclerotic manifestations are more common and precocious in diabetics than in the general population. Due to the increased cardiovascular risk, a primary or secondary (to diabetes mellitus) lipoprotein disorder in diabetics has to be carefully considered. 27 diabetics (15 NIDDM and 12 IDDM) with dyslipidemia (14 type IV, 8 type IIa and 5 type IIb) were divided in 3 groups and treated with 3 different hypolipemic drugs (Group A: pantethine 600 mg/day; Group B: acipimox 500 mg/day; Group C: bezafibrate 600 mg/day) to test their efficacy and acceptancy. Body weight, Hb A1-c, serum lipoproteins have been measured before and during the 6 months treatment. A significant variation of lipidemic pattern was observed in Group C: a decrease of cholesterol (-20%), triglycerides (-40%), LDL (-24.4%) and apo B (-26.8%) with an increase of HDL (+23.6%). Pantethine and acipimox were more effective on triglycerides (-37.7% and -23.3% respectively). Cardiovascular risk (CT tot/CT HDL) was significantly reduced with acipimox and normalized with bezafibrate.
动脉粥样硬化表现在糖尿病患者中比在普通人群中更常见且出现得更早。由于心血管风险增加，必须仔细考虑糖尿病患者原发性或继发性（继发于糖尿病）脂蛋白紊乱的情况。27例患有血脂异常（14例IV型、8例IIa型和5例IIb型）的糖尿病患者（15例非胰岛素依赖型糖尿病和12例胰岛素依赖型糖尿病）被分为3组，并用3种不同的降血脂药物进行治疗（A组：泛硫乙胺600毫克/天；B组：阿西莫司500毫克/天；C组：苯扎贝特600毫克/天），以测试其疗效和耐受性。在6个月治疗前及治疗期间测量了体重、糖化血红蛋白、血清脂蛋白。C组观察到血脂模式有显著变化：胆固醇降低（-20%）、甘油三酯降低（-40%）、低密度脂蛋白降低（-24.4%）和载脂蛋白B降低（-26.8%），同时高密度脂蛋白升高（+23.6%）。泛硫乙胺和阿西莫司对甘油三酯的作用更明显（分别降低-37.7%和-23.3%）。阿西莫司显著降低了心血管风险（总胆固醇/高密度脂蛋白胆固醇），苯扎贝特使其恢复正常。
