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目的:观察高血压前期伴发糖耐量减低患者血清脂联素、瘦素水平及阿卡波糖干预的影响。方法:入选高血压前期伴发糖耐量减低患者105例(研究组)及健康对照组28例。研究组服用阿卡波糖50mg/次、3次/d,进行为期12周的临床观察;测量两组初始及药物处理后血清脂联素与瘦素水平、血脂、空腹及餐后2h血糖(2hPG)、超敏CRP(hs-CRP)及BMI,并予相关性分析。结果:干预前,研究组较对照组脂联素值低[(6.324±2.871)μg/ml∶(7.438±3.514)μg/ml,P=0.039],而瘦素水平在两组间差异无统计学意义;Pearson相关分析提示,脂联素水平与平均动脉压、2hPG及hs-CRP呈负相关性(均P<0.05),瘦素水平与BMI、平均动脉压、空腹血糖、hs-CRP、2hPG呈正相关性(均P<0.05);研究组使用阿卡波糖干预3个月后,2hPG、胰岛素抵抗指数(HOMA-IR)、空腹血清胰岛素(FINS)与hs-CRP均较干预前明显降低,脂联素水平明显升高(均P<0.05)。结论:高血压前期伴发糖耐量减低患者血清脂联素与瘦素水平较正常人有差异,但只有脂联素差异有统计学意义,提示脂联素可作为此类人群早期评价胰岛素抵抗程度的新指标;阿卡波糖可降低餐后血糖,可能通过减少胰岛素抵抗及减轻炎症反应延缓高血压及糖耐量减低的病程进展。
Objective: To observe the effects of acarbose on serum adiponectin, leptin level and prehypertension patients with impaired glucose tolerance. Methods: A total of 105 patients (study group) and 28 healthy controls were enrolled in the prehypertension group with impaired glucose tolerance. The study group took acarbose 50mg / times, 3 times / d, for a period of 12 weeks of clinical observation; two groups of initial and drug treatment serum adiponectin and leptin levels, serum lipids, fasting and postprandial blood glucose 2h 2hPG), hypersensitive CRP (hs-CRP) and BMI, and the correlation analysis. Results: Before intervention, the level of adiponectin in the study group was significantly lower than that of the control group [(6.324 ± 2.871) μg / ml: (7.438 ± 3.514) μg / ml, P = 0.039] The Pearson correlation analysis indicated that there was a negative correlation between adiponectin level and mean arterial pressure, 2hPG and hs-CRP (all P <0.05). Leptin level was positively correlated with BMI, mean arterial pressure, fasting blood glucose, hs-CRP, (P <0.05). After 3 months of intervention with acarbose, 2hPG, insulin resistance index (HOMA-IR), fasting serum insulin (FINS) and hs-CRP in study group were significantly higher than those before intervention Decreased, adiponectin levels were significantly increased (all P <0.05). Conclusions: Serum levels of adiponectin and leptin in prehypertensive patients with impaired glucose tolerance are different than those in normal subjects, but only adiponectin is statistically significant, suggesting that adiponectin can be used as early assessment of insulin resistance in this population Acarbose can reduce postprandial blood glucose, which may delay the progression of hypertension and impaired glucose tolerance by decreasing insulin resistance and reducing inflammation.