Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
J Renin Angiotensin Aldosterone Syst. 2013 Mar;14(1):51-5. doi: 10.1177/1470320312452028. Epub 2012 Jul 16.
Pioglitazone ameliorates insulin resistance, but has an adverse effect of oedema that may result in subsequent heart failure, especially in diabetic patients with coronary artery disease. In this study, we evaluated the effects of low-dose pioglitazone on glucose control, lipid profiles, renin-angiotensin-aldosterone (RAA) system and natriuretic peptides in diabetic patients with coronary artery disease.
and results: We studied 22 diabetic patients with coronary artery disease and more than 40% of left ventricular ejection fraction (LVEF). Patients were treated with 15 mg of pioglitazone for 12 weeks, in addition to their other hypoglycaemic agents. Pioglitazone significantly decreased fasting blood glucose (155.2±52.9 mg/dl to 131.1±38.4 mg/dl, p<0.01) and haemoglobin A1C (7.13±0.44 to 6.69±0.47, p<0.001). It did not affect low-density lipoprotein cholesterol and high-density lipoprotein cholesterol, but significantly decreased triglyceride (115.6±28.8 mg/dl to 99.4±30.0 mg/dl, p<0.05) and atherogenic index of plasma (0.28±0.17 to 0.19±0.16, p<0.05). Pioglitazone did not affect plasma renin activity, plasma aldosterone, human atrial natriuretic peptide or N-terminal pro-brain natriuretic peptide.
Our data suggested that low-dose pioglitazone was a safe and useful agent at least in diabetic patients with coronary artery disease and preserved LVEF.
吡格列酮可改善胰岛素抵抗，但会引起水肿，从而导致心力衰竭，尤其对于合并冠状动脉疾病的糖尿病患者。在本研究中，我们评估了小剂量吡格列酮对合并冠状动脉疾病且左心室射血分数（LVEF）＞40%的糖尿病患者的血糖控制、血脂谱、肾素-血管紧张素-醛固酮（RAA）系统和利钠肽的影响。
我们研究了 22 例合并冠状动脉疾病且 LVEF＞40%的糖尿病患者，患者在使用其他降糖药物的基础上加用 15 mg 吡格列酮，治疗 12 周。吡格列酮可显著降低空腹血糖（从 155.2±52.9 mg/dl 降至 131.1±38.4 mg/dl，p＜0.01）和糖化血红蛋白（从 7.13±0.44 降至 6.69±0.47，p＜0.001）。吡格列酮对低密度脂蛋白胆固醇和高密度脂蛋白胆固醇无影响，但可显著降低甘油三酯（从 115.6±28.8 mg/dl 降至 99.4±30.0 mg/dl，p＜0.05）和血浆致动脉粥样硬化指数（从 0.28±0.17 降至 0.19±0.16，p＜0.05）。吡格列酮对血浆肾素活性、血浆醛固酮、人心房利钠肽或 N 末端脑利钠肽前体无影响。
我们的数据表明，小剂量吡格列酮对合并冠状动脉疾病且 LVEF 正常的糖尿病患者是一种安全且有用的药物。
