Comparison of Effects of α-Glucosidase Inhibitors and Glinide Drugs on Endothelial Dysfunction in Diabetic Patients With Coronary Artery Disease
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概要
- 論文の詳細を見る
Background: Studies have shown that repeated post-prandial hyperglycemia may play an important role in the development of atherosclerosis by suppressing endothelial function. α-Glucosidase inhibitors (α-GIs), which reduce post-prandial hyperglycemia without stimulating insulin secretion, significantly reduce the risk of coronary artery disease (CAD), whereas glinides, which improve post-prandial hyperglycemia through post-prandial insulin secretion, do not appear to affect CAD. Methods and Results: A total of 104 diabetic patients with CAD were randomly divided into 2 groups: those treated with miglitol (M-group; n=52) and those treated with nateglinide (N-group; n=52). After 4 months' treatment, although hemoglobin A1c and 1,5-anhydroglucitol were significantly improved in both groups, only the M-group had significant reductions in insulin resistance index and triglyceride/high-density lipoprotein cholesterol (TG/HDL-C; a beneficial index for assessing the presence of small dense low-density lipoprotein, and a marker of atherogenic dyslipidemia). Furthermore, only the M-group had improvement in percentage flow-mediated dilatation (%FMD) and reactive oxygen metabolites. In the M-group, multiple regression analysis showed that improvement in TG/HDL-C, in addition to 1,5-anhydroglucitol, was an independent predictor of improvement in %FMD. Conclusions: The ameliorating effect of α-GI on post-prandial hyperglycemia without stimulating insulin secretion may improve atherogenic dyslipidemia by reducing insulin resistance. These effects are associated with its beneficial impact on oxidative stress, consequently leading to an improvement in endothelial dysfunction.
- 一般社団法人 日本循環器学会の論文
著者
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Yokoyama Mitsuhiro
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University
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Sawada Takahiro
Division Of Cardiovascular Medicine Department Of Internal Medicine Kobe University Graduate School
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Shiotani Hideyuki
Department Of Cardiology Hyogo Medical Center For Adults
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Yokoyama Mitsuhiro
Division of Cardiovascular Medicine, Himeji Brain and Heart Center
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Terashita Daisuke
Division of Cardiovascular Medicine, Department of Internal Medicine, Hyogo Prefectural Awaji Hospital
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Nagasawa Yoshinori
Division of Cardiovascular Medicine, Department of Internal Medicine, Hyogo Prefectural Awaji Hospital
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Kim Su-shiku
Division of Cardiovascular Medicine, Department of Internal Medicine, Hyogo Prefectural Awaji Hospital
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Koide Masanobu
Koide Clinic
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Sawada Takahiro
Division of Cardiovascular Medicine, Himeji Brain and Heart Center
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Shiotani Hideyuki
Department of Preventive Medicine, Kobe University Graduate School of Preventive Medicine
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