加倍剂量阿托伐他汀干预对2型糖尿病患者脂代谢、胰岛素抵抗及颈动脉粥样硬化的影响

摘要

Objective: To study the effect of doubling-dose atorvastatin intervention on lipid metabolism, insulin resistance and carotid atherosclerosis in patients with type 2 diabetes mellitus.Methods: A total of 118 patients with type 2 diabetes mellitus treated in our hospital between May 2013 and December 2016 were collected, random number table was used to divide them into the single dose group (n=59) who received single-dose atorvastatin (20 mg/time, 1 times/d) therapy and the double dose group (n=59) who received doubling-dose atorvastatin (40 mg/time, 1 times/d) therapy, and both therapies lasted for 3 months.Serum levels of lipid metabolism indexes, insulin resistance indexes and carotid atherosclerosis-related indexes were compared between the two groups of patients before and after treatment.Results: Before treatment, differences in serum levels of lipid metabolism indexes, insulin resistance indexes and carotid atherosclerosis-related indexes were not statistically significant between two groups of patients (P>0.05).After treatment, serum lipid metabolism indexes TC, TG, FFA and LDL-C contents of observation group were lower than those of control group while HDL-C content was higher than that of control group;serum insulin resistance indexes INS and HOMA-IR levels were lower than those of control group while HOMA-β level was higher than that of control group;serum carotid atherosclerosis-related indexes visfatin, OPG, CysC and HMGB1 contents were lower than those of control group (P<0.05).Conclusions: Doubling-dose atorvastatin may be more effective in decreasing the hyperlipidemia and reducing the insulin resistance and carotid atherosclerosis in patients with type 2 diabetes mellitus.%目的:探讨加倍剂量阿托伐他汀干预对2型糖尿病患者脂代谢、胰岛素抵抗及颈动脉粥样硬化的影响.方法:收集在本院接受治疗的2型糖尿病患者118例,按照随机数表法分为接受单倍剂量阿托伐他汀(20 mg/次,1次/d)治疗的单倍剂量组、接受加倍剂量阿托伐他汀(40 mg/次,1次/d)治疗的加倍剂量组各59例,均持续治疗3月.对比两组治疗前后血清中脂质代谢指标、胰岛素抵抗指标、颈动脉粥样硬化相关指标水平的差异.结果:治疗前,两组血清中脂质代谢指标、胰岛素抵抗指标、颈动脉粥样硬化相关指标水平的差异无统计学意义(P>0.05).治疗后,观察组血清中脂质代谢指标TC、TG、FFA、LDL-C的含量低于对照组,HDL-C的含量高于对照组;血清中胰岛素抵抗指标INS、HOMA-IR的水平低于对照组,HOMA-β水平高于对照组;血清中颈动脉粥样硬化相关指标visfatin、OPG、CysC、HMGB1的含量低于对照组患者(P<0.05).结论:加倍剂量阿托伐他汀可更为有效的降低2型糖尿病患者的高脂血症,减轻胰岛素抵抗及颈动脉粥样硬化.