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首页> 外文期刊>JACC. Cardiovascular imaging. >Pioglitazone attenuates atherosclerotic plaque inflammation in patients with impaired glucose tolerance or diabetes a prospective, randomized, comparator-controlled study using serial FDG PET/CT imaging study of carotid artery and ascending aorta.
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Pioglitazone attenuates atherosclerotic plaque inflammation in patients with impaired glucose tolerance or diabetes a prospective, randomized, comparator-controlled study using serial FDG PET/CT imaging study of carotid artery and ascending aorta.

机译：吡格列酮可减轻葡萄糖耐量下降或糖尿病患者的动脉粥样硬化斑块炎症，这是一项前瞻性，随机，比较者对照研究，采用连续FDG PET / CT成像研究颈动脉和升主动脉。

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OBJECTIVES: The aim of this study was to compare the effect of pioglitazone, an insulin sensitizer, with glimepiride, an insulin secretagogue, on atherosclerotic plaque inflammation by using serial (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging. BACKGROUND: Atherosclerosis is intrinsically an inflammatory disease. Although hyperglycemia is associated with an increased risk of atherosclerotic cardiovascular disease, there are no clinical data to show the preference of any specific oral hypoglycemic agents to prevent atherosclerotic plaque inflammation. METHODS: A total of 56 impaired glucose tolerant or diabetic patients with carotid atherosclerosis underwent a complete history, determinations of blood chemistries, anthropometric variables, and FDG-PET. They were randomly assigned to receive either pioglitazone (15 to 30 mg) or glimepiride (0.5 to 4.0 mg) for 4 months with titration to optimal dosage. Effects of the drugs on atherosclerotic plaque inflammation were evaluated by FDG-PET at study completion. Plaque inflammation was measured by blood-normalized standardized uptake value, known as a target-to-background ratio. RESULTS: The study was completed in 31 pioglitazone-treated patients and 21 glimepiride-treated patients. Although both treatments reduced fasting plasma glucose and hemoglobin A1c values comparably, pioglitazone, but not glimepiride, decreased atherosclerotic plaque inflammation. Compared with glimepiride, pioglitazone significantly increased high-density lipoprotein cholesterol level. High-sensitivity C-reactive protein was decreased by pioglitazone, whereas it was increased by glimepiride. Multiple stepwise regression analysis revealed that the increase in high-density lipoprotein cholesterol level was independently associated with the attenuation of plaque inflammation. CONCLUSIONS: Our present study suggests that pioglitazone could attenuate atherosclerotic plaque inflammation in patients with impaired glucose tolerance or in diabetic patients independent of glucose lowering effect. Pioglitazone may be a promising strategy for the treatment of atherosclerotic plaque inflammation in impaired glucose tolerance or diabetic patients. (Detection of Plaque Inflammation and Visualization of Anti-Inflammatory Effects of Pioglitazone on Plaque Inflammation in Subjects With Impaired Glucose Tolerance and Type 2 Diabetes Mellitus by FDG-PET/CT; NCT00722631).
机译：目的：本研究的目的是通过使用系列（18）F-氟代脱氧葡萄糖正电子发射断层显像（FDG-PET）成像来比较胰岛素增敏剂吡格列酮和胰岛素促分泌剂格列美脲对动脉粥样硬化斑块炎症的影响。背景：动脉粥样硬化本质上是一种炎症性疾病。尽管高血糖与动脉粥样硬化性心血管疾病的风险增加有关，但尚无临床数据显示偏爱使用任何特定的口服降糖药来预防动脉粥样硬化斑块发炎。方法：总共56名患有葡萄糖耐量下降或糖尿病的颈动脉粥样硬化患者经历了完整的病史，血液化学测定，人体测量学变量和FDG-PET。他们被随机分配接受吡格列酮（15至30毫克）或格列美脲（0.5至4.0毫克）4个月，并以最佳剂量进行滴定。在研究完成时，通过FDG-PET评估药物对动脉粥样硬化斑块炎症的影响。斑块炎症通过血液标准化标准化摄取值（称为目标与背景之比）进行测量。结果：该研究在31例吡格列酮治疗的患者和21例格列美脲治疗的患者中完成。尽管两种治疗都可比较降低空腹血糖和血红蛋白A1c值，但吡格列酮而非格列美脲可减少动脉粥样硬化斑块炎症。与格列美脲相比，吡格列酮显着增加了高密度脂蛋白胆固醇水平。吡格列酮可降低高敏C反应蛋白，而格列美脲则可提高高敏C反应蛋白。多重逐步回归分析表明，高密度脂蛋白胆固醇水平的升高与斑块炎症的减轻独立相关。结论：我们目前的研究表明吡格列酮可以减轻葡萄糖耐量受损患者或糖尿病患者的动脉粥样硬化斑块炎症，而与降低血糖的作用无关。吡格列酮可能是治疗糖耐量减低或糖尿病患者的动脉粥样硬化斑块炎症的一种有前途的策略。 （FDG-PET / CT; NCT00722631）（检测葡萄糖斑变性和吡格列酮对葡萄糖耐量受损和2型糖尿病患者斑块炎症的抗炎作用的可视化）

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