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目的:探讨冠心病(CHD)合并糖耐量受损患者的血清脂联素和瘦素水平及阿卡波糖的干预效果。方法:将46例CHD患者按照口服葡萄糖耐量(OGTT)试验分为单纯CHD组(27例)和CHD伴糖耐量受损(IGT)组(19例),33例体检者也根据OGTT试验分为正常对照组(18例)和单纯IGT组(15例)。测定受试者血清脂联素和瘦素水平,记录OGTT试验结果,检测血脂、超敏C反应蛋白(hs-CRP)、空腹胰岛素,并测量身高、体重、腰围等。对CHD并IGT组和单纯IGT组均给予阿卡波糖干预3个月后复测上述指标。结果:血清脂联素水平在CHD患者中降低,合并IGT时更加显著,其水平与HDL-C、HOMA-IR、SBP及性别相关。血清瘦素水平在IGT患者中升高,其水平与腰围、BMI相关,女性显著高于男性。经阿卡波糖干预后,血清脂联素水平显著升高,TC的变化与其升高的水平相关;血清瘦素水平降低,女性降低更甚。结论:阿卡波糖可改变CHD合并IGT患者血清脂联素和瘦素水平,并可能通过其变化来改善餐后高血糖、血脂紊乱、肥胖及胰岛素抵抗等,从而发挥其心血管保护作用。
Objective: To investigate the serum levels of adiponectin and leptin in patients with coronary heart disease (CHD) complicated with impaired glucose tolerance and the effect of acarbose intervention. Methods: 46 CHD patients were divided into simple CHD group (n = 27) and IGT group (n = 19) according to oral glucose tolerance test (OGTT). 33 subjects were also divided according to OGTT test Normal control group (18 cases) and simple IGT group (15 cases). Serum levels of adiponectin and leptin were measured. OGTT test results were recorded. Serum lipids, hs-CRP and fasting insulin were measured. Height, weight and waist circumference were measured. The CHD and IGT group and IGT group were given acarbose intervention after 3 months retest these indicators. Results: Serum adiponectin levels were decreased in patients with CHD, and were more significantly associated with IGT. The levels were related to HDL-C, HOMA-IR, SBP and gender. Serum leptin levels increased in patients with IGT, the level of waist circumference and BMI, women were significantly higher than men. Interfering with acarbose, serum adiponectin levels were significantly increased, TC changes associated with its elevated levels; serum leptin levels decreased, women even worse. Conclusion: Acarbose can change the level of serum adiponectin and leptin in patients with CHD complicated with IGT, and may improve its postprandial hyperglycemia, dyslipidemia, obesity and insulin resistance through its changes and thus exert its cardiovascular protective effect.