Miyazaki Y, DeFronzo R A
Department of Medicine, Diabetes Division, University of Texas Health Science Center, San Antonio, TX 78229-3900, USA.
Diabetes Obes Metab. 2008 Dec;10(12):1204-11. doi: 10.1111/j.1463-1326.2008.00880.x. Epub 2008 May 12.
We examined the effects of rosiglitazone treatment on profiles of adipocytokines levels, postprandial insulin and glucose excursion, lipids levels, comparing with those of pioglitazone treatment in patients with type 2 diabetes mellitus (T2DM).
Changes in body weight, haemoglobin A(1c )(HbA(1c)), glucose/insulin/C-peptide/free fatty acid (FFA) during 75 g oral glucose tolerance test (OGTT), HDL-/LDL-cholesterol, triglyceride (TG) and adipocytokines [tumour necrosis factor (TNF)-alpha, leptin and adiponectin] were measured in T2DM patients treated with rosiglitazone, 8 mg/day (n = 35), or pioglitazone, 45 mg/day (n = 21), for 3 months.
After rosiglitazone or pioglitazone treatment, HbA(1c )(8.6-7.2 vs. 8.3-6.9%, rosiglitazone vs. pioglitazone), fasting plasma glucose (190-144 vs. 178-140 mg/dl), fasting FFA (729-595 vs. 641-526 microEq/l), mean plasma glucose-OGTT (292-229 vs. 285-233 mg/dl) and mean FFA-OGTT (580-430 vs. 488-377 microEq/l) decreased similarly and all were statistically significant (p < 0.01). The insulinogenic index (DeltaI(0-120)/DeltaG(0-120)) (0.19-0.30 vs. 0.17-0.26) and Matsuda index of insulin sensitivity (2.0-3.1 and 2.7-4.3) increased (p < 0.01) similarly, despite increase in body weight (85-88 vs. 81-84 kg). TNF-alpha (3.8-3.4 vs. 5.2-4.5 pg/ml) decreased (p < 0.05) and adiponectin (6.3-17.8 vs. 7.1-16.4 microg/ml) increased (p < 0.01), while leptin did not change following either treatment. After rosiglitazone treatment, plasma HDL-cholesterol (34-38 mg/dl) and LDL-cholesterol (103-120 mg/dl) increased (p < 0.01), while TGs (177-167 mg/dl) did not change significantly. After pioglitazone treatment, plasma HDL-cholesterol (34-37 mg/dl) increased (p < 0.05), while LDL-cholesterol (104-105 mg/dl) did not change and TGs (153-106 mg/dl) decreased (p < 0.01).
Rosiglitazone and pioglitazone have similar beneficial effects on glycaemic control insulin sensitivity, insulin secretion and plasma adipocytokine levels. However, pioglitazone has a more beneficial effect on the plasma lipid profile than rosiglitazone.
我们研究了罗格列酮治疗对2型糖尿病（T2DM）患者脂肪细胞因子水平、餐后胰岛素和血糖波动、血脂水平的影响，并与吡格列酮治疗的效果进行比较。
测量了接受罗格列酮（8毫克/天，n = 35）或吡格列酮（45毫克/天，n = 21）治疗3个月的T2DM患者的体重、糖化血红蛋白（HbA(1c)）、75克口服葡萄糖耐量试验（OGTT）期间的葡萄糖/胰岛素/C肽/游离脂肪酸（FFA）、高密度脂蛋白/低密度脂蛋白胆固醇、甘油三酯（TG）以及脂肪细胞因子[肿瘤坏死因子（TNF）-α、瘦素和脂联素]的变化。
罗格列酮或吡格列酮治疗后，HbA(1c)（8.6 - 7.2%对8.3 - 6.9%，罗格列酮对吡格列酮）、空腹血糖（190 - 144对178 - 140毫克/分升）、空腹FFA（729 - 595对641 - 526微当量/升）、OGTT平均血糖（292 - 229对285 - 233毫克/分升）和OGTT平均FFA（580 - 430对488 - 377微当量/升）均有相似程度下降，且均具有统计学意义（p < 0.01）。胰岛素生成指数（DeltaI(0 - 120)/DeltaG(0 - 120)）（0.19 - 0.30对0.17 - 0.26）和松田胰岛素敏感性指数（2.0 - 3.1和2.7 - 4.3）也有相似程度升高（p < 0.01），尽管体重有所增加（85 - 88对81 - 84千克）。TNF-α（3.8 - 3.4对5.2 - 4.5皮克/毫升）下降（p < 0.05），脂联素（6.3 - 17.8对7.1 - 16.4微克/毫升）升高（p < 0.01），而两种治疗后瘦素均未改变。罗格列酮治疗后，血浆高密度脂蛋白胆固醇（34 - 38毫克/分升）和低密度脂蛋白胆固醇（103 - 120毫克/分升）升高（p < 0.01），而TGs（177 - 167毫克/分升）无显著变化。吡格列酮治疗后，血浆高密度脂蛋白胆固醇（34 - 37毫克/分升）升高（p < 0.05），而低密度脂蛋白胆固醇（104 - 105毫克/分升）无变化，TGs（153 - 106毫克/分升）下降（p < 0.01）。
罗格列酮和吡格列酮在血糖控制、胰岛素敏感性、胰岛素分泌及血浆脂肪细胞因子水平方面具有相似的有益作用。然而，吡格列酮在血浆脂质谱方面比罗格列酮具有更有益的作用。
