第一部分 吡格列酮和或生活方式宣教对非糖尿病的高甘油三酯血症人群胰岛素抵抗和胰岛细胞功能的影响——脂毒性2年前瞻性干预研究;第二部分 基础胰岛素或每日两次预混胰岛素联合口服降糖药治疗的疗效和安全性比较-内分泌和代谢病学专业论文.pdf.docxVIP

结论在非糖尿病的高TG血症人群应用吡格列酮可能通过改善脂肪组织功能来 结论在非糖尿病的高TG血症人群应用吡格列酮可能通过改善脂肪组织功能来 降低FFA水平，升高脂联素、降低TNF—a等途径改善胰岛素敏感性和B细胞功 能，并进一步降低糖尿病和，tL,血管疾病发生风险。单纯生活方式宣教干预力度较 弱且难以持久。 【关键词】脂毒性糖尿病吡格列酮 2 英文摘要Lifestyle 英文摘要 Lifestyle or pioglitazone intervention on insulin resistance and p cell function in nondiabetic subj ects with hypertriglyceridaemia ——a two-year-prospective study on lipotoxicity OBJECTIVE--To explo∞the effects and strategies of lifestyle or／and pioglitazone intervention on lipotoxicity． RESEARCH DESIGN and METHODS---Nondiabetic subjects 奶吐l hypertriglyceridaemia(TG 2．26-4．52mmol／L)were randomly assigned to receive one tablet of placebo(CON)or diet and exercise education#us one tablet of placebo(LIF)；or diet and exercise education plus 1 5 me／day pioglitazone(PIO)for 24months．Before and during the intervention,body composition,body fat distribution [waist circumference(WR)，waist-to—hip ratio(WHR)]，plasma adiponectin,plasma TNF—a，urine albumin／creatine ratio(UACR)，insulin sensitivity and p cell function were ass懿sed． RESULTS---We enrolled 97subjects in this study[baseline data：BMI 26．8+3．1 kg／m2，WHR 0．974-0．04，FFA 0．5mmol／L(0．4_—0．7)，TG 2．93retool／L(2．5l—3．49)】， 66subjects completed this 2-year study At the end of the second year,compared with CON group，FFA in PIOgroup were significantly lower[0．30retool／L(0．20-0．45)Vs 0．43mmol／L(0．40—0．59)；P0．05]；WR and WHR decreased larger；plasma adiponectin were hider【7216ng／ml(4234-9261)VS 3882ng／ml(2654-5746)；PO．05】；plasma TNF—a were lower(6．38pg／ml(3．32—8．26)VS 1 2．87pg／ml(9．1 6-,20．3 1)，PO．O 1)， UACR were lower(O．31mg／mmol(0．1㈣．91)VS 2．28 mg／mmol(1．12~4．01)， P0．01)、HOMA--IR increment from baseline were smaller(O．08±0．33 VS 1．20± 0．38，P0．05)，early insulin secretion response increased larger(0．5h--insulin in OGTT：102．40 4-14．49uiu／ml VS 68．134-7．65 uiu／ml， INS(30-0)min／BG(30—0)min(IGR)：24．67 4-3．63 VS 14．16 4-2．05；all P0．05)。The decrease in plasma FFA Was strongly and independently associated with IGR2y．Some ofthe above par