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补充碧萝芷对2型糖尿病患者心血管危险因素的降低作用。

Reduction of cardiovascular risk factors in subjects with type 2 diabetes by Pycnogenol supplementation.

作者信息

Zibadi Sherma, Rohdewald Peter J, Park Danna, Watson Ronald Ross

机构信息

Nutritional Sciences Department, The University of Arizona, Tucson, AZ 85721, USA.

出版信息

Nutr Res. 2008 May;28(5):315-20. doi: 10.1016/j.nutres.2008.03.003.

Abstract

Patients with type 2 diabetes are at considerable risk of excessive morbidity and mortality from cardiovascular disease (CVD). We investigated the clinical effectiveness of Pycnogenol, a flavonoid-rich dietary supplement, in reducing antihypertensive medication use and CVD risk factors in subjects with type 2 diabetes. Forty-eight individuals were enrolled in a randomized, double-blind, placebo-controlled trial with parallel-group design. Patients were diagnosed with both type 2 diabetes and mild to moderate hypertension and were undergoing treatment with angiotensin-converting enzyme (ACE) inhibitors. Subjects were randomly assigned to receive either Pycnogenol pill (125 mg daily) or matched placebo for 12 weeks. According to the values of blood pressure (BP) measured at 2-week intervals, the pretrial ACE inhibitor dosage was left unchanged, reduced by 50%, or brought back to the pretrial dosage until a stable BP was obtained. Fasting plasma glucose, low-density lipoprotein (LDL) cholesterol, glycosylated hemoglobin (HbA1c), serum endothelin-1, and urinary albumin were evaluated monthly. Pycnogenol treatment achieved BP control in 58.3% of subjects at the end of the 12 weeks with 50% reduction in individual pretrial dose of ACE-inhibitors (P <.05). Plasma endothelin-1 decreased by 3.9 pg/mL in Pycnogenol-treated group vs 0.5 pg/mL increase in control group (P < .001). Mean HbA1c dropped by 0.8% in Pycnogenol-treated group (P < .05), whereas it decreased by 0.1% in control group. Fasting plasma glucose declined by 23.7 mg/dL in Pycnogenol-treated group vs 5.7 mg/dL in control group (P < .0001). Low-density lipoprotein cholesterol improved significantly in Pycnogenol-treated group, declining by 12.7 mg/dL (P < .001). A significant decrease in urinary albumin level was observed at week 8 compared with the control group (P < .05). However, this reduction was not significant at 12th week. After 12 weeks of supplementation, Pycnogenol resulted in improved diabetes control, lowered CVD risk factors, and reduced antihypertensive medicine use vs controls.

摘要

2型糖尿病患者面临着因心血管疾病(CVD)导致的过高发病率和死亡率的重大风险。我们研究了富含黄酮类化合物的膳食补充剂碧萝芷(Pycnogenol)在减少2型糖尿病患者抗高血压药物使用和降低CVD风险因素方面的临床效果。48名个体参与了一项采用平行组设计的随机、双盲、安慰剂对照试验。患者被诊断患有2型糖尿病和轻度至中度高血压,并且正在接受血管紧张素转换酶(ACE)抑制剂治疗。受试者被随机分配接受碧萝芷片(每日125毫克)或匹配的安慰剂,为期12周。根据每隔2周测量的血压(BP)值,试验前的ACE抑制剂剂量保持不变、减少50%或恢复到试验前剂量,直到获得稳定的血压。每月评估空腹血糖、低密度脂蛋白(LDL)胆固醇、糖化血红蛋白(HbA1c)、血清内皮素-1和尿白蛋白。在12周结束时,碧萝芷治疗使58.3%的受试者实现了血压控制,个体试验前ACE抑制剂剂量降低了50%(P<.05)。碧萝芷治疗组的血浆内皮素-1下降了3.9 pg/mL,而对照组增加了0.5 pg/mL(P<.001)。碧萝芷治疗组的平均HbA1c下降了0.8%(P<.05),而对照组下降了0.1%。碧萝芷治疗组的空腹血糖下降了23.7 mg/dL,而对照组下降了5.7 mg/dL(P<.0001)。碧萝芷治疗组的低密度脂蛋白胆固醇显著改善,下降了12.7 mg/dL(P<.001)。与对照组相比,在第8周观察到尿白蛋白水平显著下降(P<.05)。然而,在第12周时这种下降并不显著。补充12周后,与对照组相比,碧萝芷改善了糖尿病控制,降低了CVD风险因素,并减少了抗高血压药物的使用。

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