Hsieh Ching-Jung, Wang Pei-Wen
Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Circ J. 2009 May;73(5):948-54. doi: 10.1253/circj.cj-08-0905. Epub 2009 Mar 12.
Peripheral arterial occlusion disease (PAOD) is caused mainly by chronic inflammation and endothelium dysfunction, and is often treated with cilostazol. However, because this drug's influence on atherogenic cytokines is still not well known, this study examined the effect of cilostazol on the serum levels of soluble CD40 ligand (sCD40L), adiponectin and high-sensitivity C-reactive protein (hs-CRP) in patients with type 2 diabetes and PAOD.
The 92 type 2 diabetics with PAOD and 100 non-PAOD diabetics were enrolled and randomly assigned to a group receiving either cilostazol or placebo for 6 months. The atherogenic cytokines were measured at the beginning and completion of the study. In the PAOD groups, those in the cilostazol group had significant changes in the levels of hs-CRP, sCD40L and adiponectin (P=0.001, P=0.05, P=0.004, respectively). Changes in the levels of adiponectin and sCD40L were more significant in the PAOD group treated with cilostazol than in the non-PAOD group also treated with the drug (P=0.01 and P=0.008, respectively).
Cilostazol can decrease hs-CPR and sCD40L levels and increase that of adiponectin, and then delay the progression of atherogenesis and chronic inflammation in type 2 diabetics, especially those with PAOD.
外周动脉闭塞性疾病（PAOD）主要由慢性炎症和内皮功能障碍引起，通常用西洛他唑治疗。然而，由于这种药物对致动脉粥样硬化细胞因子的影响仍不明确，本研究检测了西洛他唑对2型糖尿病合并PAOD患者血清可溶性CD40配体（sCD40L）、脂联素和高敏C反应蛋白（hs-CRP）水平的影响。
纳入92例2型糖尿病合并PAOD患者和100例非PAOD糖尿病患者，随机分为接受西洛他唑或安慰剂治疗6个月的组。在研究开始和结束时测量致动脉粥样硬化细胞因子。在PAOD组中，西洛他唑组的hs-CRP、sCD40L和脂联素水平有显著变化（分别为P=0.001、P=0.05、P=0.004）。西洛他唑治疗的PAOD组脂联素和sCD40L水平的变化比同样接受该药物治疗的非PAOD组更显著（分别为P=0.01和P=0.008）。
西洛他唑可降低hs-CPR和sCD40L水平，提高脂联素水平，进而延缓2型糖尿病患者尤其是合并PAOD患者的动脉粥样硬化和慢性炎症进展。
