Miglitol improves postprandial endothelial dysfunction in patients with acute coronary syndrome and new-onset postprandial hyperglycemia.
Miglitol improves postprandial endothelial dysfunction in patients with acute coronary syndrome and new-onset postprandial hyperglycemia.
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DOI：
10.1186/1475-2840-12-92
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发表时间：
2013-06-19
影响因子：
9.3
通讯作者：
Hirayama A
中科院分区：
文献类型：
--
作者：
Kitano D;Chiku M;Li Y;Okumura Y;Fukamachi D;Takayama T;Hiro T;Saito S;Hirayama A
高血压是心血管疾病发展的危险因素，可导致内皮功能障碍。α-葡萄糖苷酶抑制剂（α-GI）可改善餐后高血糖（PPHG），并可能对相关心血管疾病产生有利影响。α-GI在急性冠状动脉综合征（ACS）和PPHG患者中的作用尚不清楚;因此，我们通过数字反应性充血外周动脉张力测定法（RH-PAT）评估了α-GI米格列醇对此类患者内皮功能的影响。54例接受直接经皮冠状动脉介入治疗的ACS患者入组研究：36例新发PPHG，18例葡萄糖耐量正常。18例PPHG患者每餐给予米格列醇50 mg，持续1周。在米格列醇治疗1周前后，根据RH-PAT指数（RHI）评估内皮功能。其余18例PPHG患者和18例NGT患者1周内不给予任何降糖药物，并评估内皮功能。PPHG患者餐后RHI显著降低。米格列醇显著改善PPHG;餐后RHI也得到改善（p = 0.007）。餐后RHI变化与餐后空腹至60分钟血糖峰值呈显著负相关（r =-0.382，p = 0.009）。此外，内皮功能的改善与米格列醇实现的餐后葡萄糖峰降低相关（r =-0.462，p = 0.001）。ACS患者餐后血糖变化与内皮功能障碍有关。基于米格列醇的PPHG改善似乎可改善内皮功能。米格列醇对葡萄糖依赖性内皮功能的影响可能改善ACS的预后。
Hyperglycemia, a risk factor for development of cardiovascular disease, causes endothelial dysfunction. Alpha-glucosidase inhibitors (α-GIs) improve postprandial hyperglycemia (PPHG) and may have favorable effects on associated cardiovascular disease. Effects of α-GIs in patients with acute coronary syndrome (ACS) and PPHG remain unclear; thus, we assessed the effect of α-GI miglitol on endothelial function in such patients by digital reactive hyperemia peripheral arterial tonometry (RH-PAT). Fifty-four patients with ACS who underwent primary percutaneous coronary intervention were enrolled in the study: 36 with new-onset PPHG and 18 with normal glucose tolerance. Eighteen PPHG patients were given 50 mg of miglitol with each meal for 1 week. Endothelial function was assessed on the basis of the RH-PAT index (RHI) before and after the 1-week miglitol treatment. The other 18 PPHG patients and the 18 NGT patients were not given any anti-diabetic agent for 1 week, and endothelial function was assessed. Postprandial RHI decreased significantly in patients with PPHG. Miglitol improved PPHG significantly; postprandial RHI also improved (p = 0.007). Significant inverse correlation was found between the postprandial change in RHI and postprandial fasting-to-60-minutes surge in glucose (r = -0.382, p = 0.009). Moreover, the improvement in endothelial function correlated with the reduced postprandial glucose surge achieved with miglitol (r = -0.462, p = 0.001). Postprandial changes in glucose are related to endothelial dysfunction in ACS. Miglitol-based improvement in PPHG appears to improve endothelial function. The effect of miglitol on glucose-dependent endothelial function might improve outcomes of ACS.
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影响因子：
8.2
作者：
Hattori, Y.;Jojima, T.;Hayashi, T.
通讯作者：
Hayashi, T.
影响因子：
39.3
作者：
Hanefeld, M;Cagatay, M;Rupp, M
通讯作者：
Rupp, M
影响因子：
158.5
作者：
Duckworth, William;Abraira, Carlos;Huang, Grant D.
通讯作者：
Huang, Grant D.
影响因子：
37.8
作者：
Evans, M;Anderson, RA;Rees, A
通讯作者：
Rees, A
影响因子：
158.5
作者：
Gerstein, Hertzel C.;Miller, Michael E.;Friedewald, William T.
通讯作者：
Friedewald, William T.