Nateglinide reduces carotid intima-media thickening in type 2 diabetic patients under good glycemic control
Nateglinide reduces carotid intima-media thickening in type 2 diabetic patients under good glycemic control
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DOI：
10.1161/atvbaha.107.152835
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发表时间：
2007-11-01
影响因子：
8.7
通讯作者：
Kawamori, Ryuzo
中科院分区：
文献类型：
--
作者：
Mita, Tomoya;Watada, Hirotaka;Kawamori, Ryuzo
2型糖尿病患者餐后高血糖是动脉粥样硬化的危险因素。本研究的目的是探讨严格的血糖控制的影响，那格列奈对颈总动脉远壁内膜中层厚度在2型糖尿病患者谁已经在良好的glycemic control.Methods和Results-We进行了一项开放标签随机前瞻性试验78药物初治2型糖尿病患者的HbA（1）c小于6.5%。38例患者被随机分配到接受那格列奈（270 mg/dL）和40名对照组（无治疗）。12个月后，在那格列奈组中观察到HbA 1c显著降低，而在未治疗组中观察到HbA 1c显著升高。与未治疗组相比，那格列奈组在1年随访结束时的颈动脉内膜中层厚度显著降低（-0.017 +/- 0.054 mm/年vs 0.024 +/- 0.066 mm/年，P = 0.0064）。而那格列奈治疗也降低了甘油三酯，高敏C-反应蛋白，E-选择素，多元回归分析确定HbA 1c作为唯一显着的独立的决定因素的变化，颈动脉内膜-中层thickness. Conclusion，在2型糖尿病患者血糖控制良好，进一步严格的血糖控制，那格列奈的结果在颈动脉内膜-中层厚度的回归。
Objective-Postprandial hyperglycemia observed in type 2 diabetes mellitus is a risk factor for atherosclerosis. The aim of this study was to investigate the effect of strict glycemic control by nateglinide on common carotid far wall intima-media thickness in type 2 diabetic patients who were already under good glycemic control.Methods and Results-We performed an open labeled randomized prospective trial on 78 drug-naive type 2 diabetic patients whose HbA(1)c was less than 6.5%. Thirty-eight patients were randomly assigned to receive nateglinide ( 270 mg/dL) and 40 to control group ( no treatment). After 12 months, a significant reduction in HbA1c was observed in the nateglinide group, whereas a significant increase of HbA1c was observed in the untreated group. The carotid intima-media thickness at the end of 1-year follow-up was significantly reduced in the nateglinide group compared with the untreated group (-0.017 +/- 0.054 mm/year versus 0.024 +/- 0.066 mm/year, P = 0.0064). Whereas nateglinide treatment also reduced triglyceride, highly-sensitive C-reactive protein, and E-selectin, multiple regression analysis identified HbA1c as the only significant independent determinant of the change in carotid intima-media thickness.Conclusion-In type 2 diabetic patients with good glycemic control, further strict glycemic control by nateglinide results in regression of carotid intima-media thickness.