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匹伐他汀对伴有高胆固醇血症的 2 型糖尿病患者糖代谢的影响。

The effects of pitavastatin on glucose metabolism in patients with type 2 diabetes with hypercholesterolemia.

机构信息

Hashima City Hospital, Gifu, Japan; Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, Gifu, Japan.

Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, Gifu, Japan.

出版信息

Diabetes Res Clin Pract. 2014 Dec;106(3):531-7. doi: 10.1016/j.diabres.2014.09.048. Epub 2014 Oct 22.

Abstract

BACKGROUND

Although there have been several reports that statins cause insulin resistance that leads to the occurrence of type 2 diabetes in Caucasians, there has been no Japanese prospective studies investigating the effects of statins on the glucose metabolism system.

MATERIALS AND METHODS

Our subjects were 86 Japanese patients with type 2 diabetes with hypercholesterolemia. Pitavastatin 2mg/day was administered for 12 months and the lipid-related values, glucose metabolism values, and the presence/absence of side effects were investigated.

RESULTS

None of these factors was found to differ between before and after administration of pitavastatin in overall analysis of all subjects. In subgroup analysis, fasting blood glucose showed a decrease in the BMI ≥ 25 group and there was a significant difference between the BMI<25 and BMI ≥2 5 groups (P-values: 0.021 and 0.0036). Although HbA1c showed an increase both in the group switched to pitavastatin and the BMI<25 group (P-values: 0.035 and 0.033) and HOMA-β showed a decrease in the BMI<25 group (P-values: 0.044), there were no significant differences in changes between each divided group and their counterparts.

CONCLUSION

In the Japanese obese group with BMI ≥ 25, pitavastatin elicited a significant decrease in fasting blood glucose. It is not clear whether or not this is due to improved insulin resistance as a direct effect of pitavastatin, but in contrast to findings in Caucasians pitavastatin does not worsen insulin resistance in Japanese patients with type 2 diabetes complicated by hypercholesterolemia.

摘要

背景

虽然有几项报告表明他汀类药物会导致胰岛素抵抗,从而导致 2 型糖尿病在白种人中发生,但还没有日本前瞻性研究调查他汀类药物对葡萄糖代谢系统的影响。

材料与方法

我们的研究对象是 86 例患有 2 型糖尿病伴高胆固醇血症的日本患者。给予患者匹伐他汀 2mg/天,治疗 12 个月,并对血脂相关值、葡萄糖代谢值和不良反应的发生情况进行了调查。

结果

在所有患者的总体分析中,未发现这些因素在匹伐他汀给药前后有差异。在亚组分析中,空腹血糖在 BMI≥25 组中降低,且 BMI<25 和 BMI≥25 组之间存在显著差异(P 值分别为 0.021 和 0.0036)。虽然 HbA1c 在换用匹伐他汀组和 BMI<25 组中均升高(P 值分别为 0.035 和 0.033),且 HOMA-β 在 BMI<25 组中降低(P 值为 0.044),但在每个分组的变化与对照组之间没有显著差异。

结论

在 BMI≥25 的日本肥胖患者中,匹伐他汀可显著降低空腹血糖。尚不清楚这是否是由于匹伐他汀的直接作用改善了胰岛素抵抗,但与白种人研究结果不同,匹伐他汀不会加重合并高胆固醇血症的 2 型糖尿病日本患者的胰岛素抵抗。

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