Vijay Sudarshan K, Mishra Manish, Kumar Hemant, Tripathi K
Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
Acta Diabetol. 2009 Mar;46(1):27-33. doi: 10.1007/s00592-008-0054-7. Epub 2008 Aug 29.
The purpose of this study was to assess the effects of PPAR-gamma agonists (pioglitazone and rosiglitazone) on mediators of endothelial dysfunction and markers of angiogenesis in patients with type-2 diabetes. Pioglitazone group showed favorable reductions in serum total cholesterol, triglycerides, LDL cholesterol, VLDL cholesterol and increase in HDL cholesterol as compared to rosiglitazone group, after 16 weeks of treatment and also with control group. There was significant reduction of CRP level in pioglitazone and rosiglitazone group. The level of serum TNF-alpha decreased significantly in pioglitazone and mildly decreased in rosiglitazone group. The level of VEGF, IL-8 and Angiogenin were increased in pioglitazone than rosiglitazone group. There were no significant changes observed in the serum angiogenin and IL-8 levels in the control group. Pioglitazone and rosiglitazone therapy in type-2 diabetes subjects have additional benefits of reducing mediators of endothelial dysfunction. Increase in angiogenesis markers in patients receiving pioglitazone could have variable effects in diabetic nephropathy and retinopathy as there may be increased vascular neogenesis. Pioglitazone has advantage over rosiglitazone in lowering lipid and proinflammatory cytokines.
本研究的目的是评估过氧化物酶体增殖物激活受体γ（PPAR-γ）激动剂（吡格列酮和罗格列酮）对2型糖尿病患者内皮功能障碍介质和血管生成标志物的影响。与罗格列酮组相比，吡格列酮组在治疗16周后以及与对照组相比，血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇、极低密度脂蛋白胆固醇均有显著降低，高密度脂蛋白胆固醇有所升高。吡格列酮组和罗格列酮组的C反应蛋白（CRP）水平均显著降低。吡格列酮组血清肿瘤坏死因子-α（TNF-α）水平显著降低，罗格列酮组轻度降低。吡格列酮组血管内皮生长因子（VEGF）、白细胞介素-8（IL-8）和血管生成素水平高于罗格列酮组。对照组血清血管生成素和IL-8水平未见显著变化。2型糖尿病患者使用吡格列酮和罗格列酮治疗有额外益处，可减少内皮功能障碍介质。接受吡格列酮治疗的患者血管生成标志物增加，可能对糖尿病肾病和视网膜病变产生不同影响，因为可能会增加血管新生。吡格列酮在降低血脂和促炎细胞因子方面优于罗格列酮。
