与glimepiride相比,pioglitazone对2型糖尿病中心动脉内膜介质厚度的影响:一项随机试验
Theodore Mazzone1, Peter M Meyer, Steven B Feinstein
1Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Illinois College of Medicine, Chicago 60612, USA. tmazzone@uic.edu
JAMA
|November 15, 2006
概括
与glimepiride相比,pioglitazone在2型糖尿病 (DM) 患者中显著减缓了18个月内动脉内心介质厚度 (CIMT) 的进展. 这表明皮奥格利塔可能在2型糖尿病中提供心血管益处.
科学领域:
- 心血管医学 心血管医学
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 动脉内心介质厚度 (CIMT) 是动脉样硬化和心血管风险的关键指标,在2型糖尿病 (DM) 中特别高.
- 之前的短期研究表明,与pioglitazone一样, thiazolidinediones可能会减缓糖尿病患者的CIMT进展,但长期数据没有确定性.
研究的目的:
- 为了比较pioglitazone与glimepiride在改变2型糖尿病患者的常见动脉CIMT中的疗效.
- 评估这些抗糖尿病药物对亚临床动脉样硬化进展的长期影响.
主要方法:
- 一个随机的,双盲的,多中心试验,涉及462名2型DM的成年人超过72周.
- 参与者接受了皮奥格利塔 (15-45毫克/天) 或格利梅皮里德 (1-4毫克/天) 作为活性比较剂.
- 使用自动边缘检测技术从带超声波图像测量平均后壁CIMT的变化.
主要成果:
- 皮奥格利塔在72周的平均CIMT进展显著减缓,与glimepiride相比 (差异: -0.013毫米;P = .02).
- 最大CIMT的进展也被皮奥格利塔与glimepiride显著减少 (差异: -0.024毫米;P = .008).
- 皮奥格利塔对CIMT的有益影响在各种患者亚组中一致.
结论:
- 在18个月的时间里,与glimepiride相比,pioglitazone在2型DM患者中有效减缓了CIMT的进展.
- 这些发现支持pioglitazone在减轻该患者群体亚临床动脉样硬化中的潜在作用.
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