过氧化物酶体增殖物激活受体-α激动剂非诺贝特可降低糖耐量受损伴高甘油三酯血症患者的胰岛素抵抗：一项横断面研究。
PPAR-α Agonist Fenofibrate Reduces Insulin Resistance in Impaired Glucose Tolerance Patients with Hypertriglyceridemia: A Cross-Sectional Study.
作者信息
Feng Xiaomeng, Gao Xia, Jia Yumei, Xu Yuan
机构信息
Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China.
出版信息
Diabetes Ther. 2017 Apr;8(2):433-444. doi: 10.1007/s13300-017-0257-4. Epub 2017 Mar 30.
INTRODUCTION
Peroxisome proliferator-activated receptor-α (PPAR-α) agonists can regulate metabolism and protect the cardiovascular system. This study investigated the effects of PPAR-α agonist fenofibrate on insulin resistance in patients with impaired glucose tolerance (IGT).
METHODS
This research evaluated cross-sectional and interventional studies. 191 subjects with IGT were divided into a hypertriglyceridemia group (HTG group, n = 118) and a normal triglyceride (TG) group (NTG group, n = 73). 79 subjects with normal glucose tolerance were recruited as a control group. The HTG group was treated with fenofibrate (200 mg/day) for 12 weeks. The homeostatic model assessment index 2 (HOMA2) and the McAuley index (McA) were calculated.
RESULTS
HOMA2 for β-cell function (HOMA2-%B) was 93.47 ± 26.28, 68.47 ± 21.29, and 79.92 ± 23.15 in HTG, NTG, and control groups, respectively. HOMA2 for insulin sensitivity (HOMA2-%S) was 48.40 (39.70, 68.70), 110.20 (62.55, 141.95), and 101.20 (79.90, 140.10) in HTG, NTG, and control groups, respectively. HOMA2 for insulin resistance (HOMA2-IR) was 2.09 (1.46, 2.52), 0.92 (0.70, 1.61), and 0.99 (0.71, 1.25) in HTG, NTG, and control groups, respectively. McA was 5.05 ± 0.76, 7.99 ± 1.79, and 8.34 ± 1.55 in HTG, NTG, and control groups, respectively. The HTG group had higher HOMA2-%B and HOMA2-IR, and lower HOMA2-%S and McA than NTG and control groups (P < 0.001 for all). Fenofibrate decreased HOMA2-%B and HOMA2-IR and increased HOMA2-%S and McA in the HTG group (HOMA2-%B: from 93.47 ± 26.28 to 89.34 ± 23.53, P = 0.018; HOMA2-%S: from 48.40 (39.70, 68.70) to 56.75 (44.88, 72.53), P < 0.001; HOMA2-IR: from 2.07 (1.46, 2.52) to 1.76 (1.38, 2.30), P < 0.001; McA: from 5.05 ± 0.76 to 9.34 ± 0.88, P < 0.001).
CONCLUSION
PPAR-α agonists improve parameters of glucoregulation in IGT patients with hypertriglyceridemia.
引言
过氧化物酶体增殖物激活受体-α（PPAR-α）激动剂可调节代谢并保护心血管系统。本研究调查了PPAR-α激动剂非诺贝特对糖耐量受损（IGT）患者胰岛素抵抗的影响。
方法
本研究评估了横断面研究和干预性研究。191例IGT患者被分为高甘油三酯血症组（HTG组，n = 118）和正常甘油三酯（TG）组（NTG组，n = 73）。招募79例糖耐量正常的受试者作为对照组。HTG组接受非诺贝特治疗（200mg/天），为期12周。计算稳态模型评估指数2（HOMA2）和麦考利指数（McA）。
结果
HTG组、NTG组和对照组的β细胞功能HOMA2（HOMA2-%B）分别为93.47±26.28、68.47±21.29和79.92±23.15。HTG组、NTG组和对照组的胰岛素敏感性HOMA2（HOMA2-%S）分别为48.40（39.70，68.70）、110.20（62.55，141.95）和101.20（79.90，140.10）。HTG组、NTG组和对照组的胰岛素抵抗HOMA2（HOMA2-IR）分别为2.09（1.46，2.52）、0.92（0.70，1.61）和0.99（0.71，1.25）。HTG组、NTG组和对照组的McA分别为5.05±0.76、7.99±1.79和8.34±1.55。HTG组的HOMA2-%B和HOMA2-IR高于NTG组和对照组，而HOMA2-%S和McA低于NTG组和对照组（所有P均<0.001）。非诺贝特使HTG组的HOMA2-%B和HOMA2-IR降低，HOMA2-%S和McA升高（HOMA2-%B：从93.47±26.28降至89.34±23.53，P = 0.018；HOMA2-%S：从48.40（39.70，68.70）升至56.75（44.88，72.53），P<0.001；HOMA2-IR：从2.07（1.46，2.52）降至1.76（1.38，2.30），P<0.001；McA：从5.05±0.76升至9.34±0.88，P<0.001）。
结论
PPAR-α激动剂可改善高甘油三酯血症的IGT患者的血糖调节参数。
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