Molavi Behzad, Rassouli Negah, Bagwe Suveer, Rasouli Neda
Central Arkansas Veterans Healthcare System, Little Rock, Arkansas 72205, USA.
Vasc Health Risk Manag. 2007;3(6):967-73.
The rising incidence of obesity and insulin resistance to epidemic proportions has closely paralleled the surge in the prevalence of diabetes and outpaced therapeutic advances in diabetes prevention and treatment. Current evidence points to obesity induced oxidative stress and chronic inflammation as the common denominators in the evolution of insulin resistance and diabetes. Of all the hypoglycemic agents in the pharmacological arsenal against diabetes, thiazolidinediones, in particular pioglitazone, as well as metformin appear to have additional effects in ameliorating oxidative stress and inflammation; rendering them attractive tools for prevention of insulin resistance and diabetes. In addition to their hypoglycemic and lipid modifying properties, pioglitazone and metformin have been shown to exert anti-oxidative and anti-inflammatory effects in vascular beds, potentially slowing the accelerated atherosclerosis in diabetes, which is the major cause of morbidity and mortality in the affected population. The combination of pioglitazone and metformin would thus appear to be an effective pharmacological intervention in prevention and treatment of diabetes. Finally, this review will address the currently available evidence on diabetic cardiomyopathy and the potential role of combination therapy with pioglitazone and metformin.
肥胖和胰岛素抵抗的发病率上升至流行程度，这与糖尿病患病率的激增密切相关，且超过了糖尿病预防和治疗方面的治疗进展。目前的证据表明，肥胖诱导的氧化应激和慢性炎症是胰岛素抵抗和糖尿病发展的共同因素。在对抗糖尿病的所有药物降糖剂中，噻唑烷二酮类药物，尤其是吡格列酮，以及二甲双胍似乎在改善氧化应激和炎症方面具有额外作用；使其成为预防胰岛素抵抗和糖尿病的有吸引力的工具。除了它们的降糖和调节血脂特性外，吡格列酮和二甲双胍已被证明在血管床中发挥抗氧化和抗炎作用，可能减缓糖尿病中加速的动脉粥样硬化，这是受影响人群发病和死亡的主要原因。因此，吡格列酮和二甲双胍的联合使用似乎是预防和治疗糖尿病的有效药物干预措施。最后，本综述将阐述目前关于糖尿病性心肌病的现有证据以及吡格列酮和二甲双胍联合治疗的潜在作用。
