제 2형 당뇨병 환자에서 인슐린 저항성 개선제가 뇌혈류 개선에 미치는 영향

Abstract

Atherogenic cerebrovascular disease is one of the major causes of morbidity and mortality in patients with type 2 diabetes mellitus. Pioglitazone is an insulin-sensitizing agent that has been reported to have antiatherogenic effect. The aim of this study was to investigate whether pioglitazone affects the cerebrovascular blood flow by reducing intima-media thickness and pulsatility index. Total of 40 type 2 diabetic patients were included and divided into two groups: the pioglitazone-treated group (pioglitazone 15 mg/day with gliclazide 80~320 mg/day for 12 weeks)(n=20) and control group (gliclazide 80~320 mg/day for 12 weeks)(n=20). The changes in lipid profile, insulin resistance, intimamedia thickness, pulsatility index were monitored to determine that pioglitazone improves cerebrovascular blood flow. The pioglitazone treatment significantly reduced total cholesterol, triglyceride, LDL-C, insulin resistance and pulsatility index. Intima-media thickness tended to decrease but was not significant. This study revealed that treatment with pioglitazone was associated with the improvement of cerebrovascular blood flow. We found that pioglitazone have improved insulin resistance, lipid profile and reduced carotid intima-media thickness and pulproliferasatility index after the 12 week adminstration. Thus, pioglitazone appears to be effective for the improvement of cerebrovascular blood flow in type 2 diabetic patients.