The effect of acarbose on insulin resistance in obese hypertensive subjects with normal glucose tolerance: a randomized controlled study
The effect of acarbose on insulin resistance in obese hypertensive subjects with normal glucose tolerance: a randomized controlled study
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DOI：
10.1111/j.1463-1326.2004.00317.x
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发表时间：
2004-01-01
影响因子：
5.8
通讯作者：
Ravid, M
中科院分区：
文献类型：
--
作者：
Rachmani, R;Bar-Dayan, Y;Ravid, M
目的：阿卡波糖是一种葡萄糖氧化酶抑制剂，可延迟葡萄糖的吸收，从而降低糖尿病患者和糖耐量受损受试者的餐后血糖水平、糖化血红蛋白 (HbA1c) 和胰岛素抵抗。迄今为止，阿卡波糖对糖耐量正常（NGT）受试者的影响尚未得到研究。本研究的目的是通过NGT检查阿卡波糖对肥胖高血压受试者的作用。方法：对56名体重指数（BMI）27-35 kg/m(2)、空腹血糖小于或等于6 mmol/l、口服糖耐量试验正常的男性高血压受试者进行双盲、平行分组研究。最初和服用阿卡波糖 150 毫克/天或安慰剂 24 周后测定血压、HbA1c、血脂和胰岛素抵抗 [稳态模型评估 (HOMA) 指数]。主要终点是胰岛素抵抗的变化。研究期间抗高血压治疗和饮食保持不变。结果：阿卡波糖使用者的胰岛素抵抗下降，但安慰剂组没有下降。阿卡波糖组的 HOMA 指数从 5.36 +/- 1.7 下降至 4.10 +/- 1.6 (p = 0.001)，安慰剂组的相应值为 5.44 +/- 1.9 和 5.53 +/- 1.7。阿卡波糖组血清甘油三酯值下降（2.16 +/- 0.16 mmol/l 至 1.76 +/- 0.15 mmol/l，p = 0.02），而安慰剂组没有变化。两组的BMI、低密度脂蛋白或高密度脂蛋白值均没有变化。两组的血压均下降，可能是由于患者依从性更好。结论：阿卡波糖也可以降低糖耐量正常的肥胖高血压受试者的胰岛素抵抗和甘油三酯。
Aim: Acarbose, a glucose oxidase inhibitor, delays the absorption of glucose thus reducing post-prandial blood glucose level, haemoglobin A1c (HbA1c) and insulin resistance in patients with diabetes mellitus and in subjects with impaired glucose tolerance. The effect of acarbose in subjects with normal glucose tolerance (NGT) has hitherto not been examined. The aim of the present study was to examine the effect of acarbose in obese hypertensive subjects with NGT.Methods: A double-blinded, parallel group study was performed on 56 male subjects with hypertension, body mass index (BMI) 27-35 kg/m(2), fasting blood glucose less than or equal to 6 mmol/l and a normal oral glucose tolerance test. Blood pressure, HbA1c, lipid profile and insulin resistance [homeostasis model assessment (HOMA) index] were determined initially and following 24 weeks of acarbose, 150 mg/day or placebo. The primary end point was the change in insulin resistance. Anti-hypertensive treatment and diet were kept constant during the study.Results: Insulin resistance decreased in acarbose users but not on placebo. HOMA index declined from 5.36 +/- 1.7 to 4.10 +/- 1.6 (p = 0.001) on acarbose, the corresponding values on placebo were 5.44 +/- 1.9 and 5.53 +/- 1.7. A decrease in serum triglyceride values (2.16 +/- 0.16 mmol/l to 1.76 +/- 0.15 mmol/l, p = 0.02) took place on acarbose with no change on placebo. There was no change in BMI, low-density lipoprotein or high-density lipoprotein values in either group. Blood pressure declined equally in both the groups, probably due to better patient compliance.Conclusions: Acarbose may reduce insulin resistance and triglycerides also in obese hypertensive subjects with normal glucose tolerance.