Agrawal Neeraj K, Maiti Rituparna, Dash D, Pandey B L
Department Of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
Pharmacol Res. 2007 Aug;56(2):118-23. doi: 10.1016/j.phrs.2007.04.007. Epub 2007 May 3.
Inflammation and oxidative stress cause genesis and progression of atherosclerosis in diabetes. This study aimed to assess effects of Cilostazol on these factors in hypertensive type 2 diabetic patients.
In randomized, open, add-on preventive controlled clinical trial design, 60 hypertensive type 2 diabetics aged >or=45 years were evaluated clinically and for total leukocyte count, erythrocyte sedimentation rate, serum albumin, serum hsC-reactive protein, plasma malondialdehyde, blood reduced glutathione and HbA1c levels. After informed consent, 30 patients received Cilostazol (100mg) twice daily orally as add-on therapy. At 1 month follow-up, 26 patients in control group and 22 patients in Cilostazol group completed the trial and particular parameters were re-evaluated.
The mean age and duration of diabetes were 55+/-7 years and 8+/-6 years, respectively. At follow-up, the Cilostazol group showed significant (p<0.001) decrease in hsC-reactive protein (23.6%), erythrocyte sedimentation rate (38.7%), total leukocyte count (12.6%), plasma malondialdehyde (17.6%), HbA1c (0.17%, p=0.002) and increase in serum albumin (11.9%), blood reduced glutathione (3.5%) from baseline. UKPDS 10 years risk of coronary heart disease decreased by 6% (p=0.002). The control group did not show significant improvement in inflammatory profile, oxidative status and HbA1c.
Inflammatory and oxidative stress is high in hypertensive type 2 diabetic patients. Cilostazol reduces these factors as well as coronary heart disease risk in diabetes mellitus.
炎症和氧化应激导致糖尿病患者动脉粥样硬化的发生和发展。本研究旨在评估西洛他唑对高血压2型糖尿病患者这些因素的影响。
采用随机、开放、附加预防对照临床试验设计，对60例年龄≥45岁的高血压2型糖尿病患者进行临床评估，并检测其白细胞总数、红细胞沉降率、血清白蛋白、血清高敏C反应蛋白、血浆丙二醛、血液还原型谷胱甘肽和糖化血红蛋白水平。在获得知情同意后，30例患者接受西洛他唑（100mg）口服，每日两次，作为附加治疗。在1个月的随访中，对照组26例患者和西洛他唑组22例患者完成了试验，并对特定参数进行了重新评估。
糖尿病患者的平均年龄和病程分别为55±7岁和8±6年。随访时，西洛他唑组的高敏C反应蛋白（23.6%）、红细胞沉降率（38.7%）、白细胞总数（12.6%）、血浆丙二醛（17.6%）、糖化血红蛋白（0.17%，p=0.002）较基线水平显著降低（p<0.001），血清白蛋白（11.9%）、血液还原型谷胱甘肽（3.5%）较基线水平显著升高。英国前瞻性糖尿病研究（UKPDS）显示冠心病10年风险降低了6%（p=0.002）。对照组在炎症指标、氧化状态和糖化血红蛋白方面未显示出显著改善。
高血压2型糖尿病患者炎症和氧化应激水平较高。西洛他唑可降低这些因素以及糖尿病患者的冠心病风险。
