Effects Of Rosiglitazone On Carotid Intima-media Thickness In Patients With Type 2 Diabetes Mellitus

Objective:To analyze the relationship between insulin resistance , blood pressure, blood glucose level, blood lipid level, serum highsensitive c-reavtive protein and carotid intima-media thickness which has been recognized a clinical substitute index to evaluate early coronary atherosclerotic lesions in type 2 diabetes mellitus, and observe the therapeutic effects of rosiglitazone(thiazolidinediones),and then investigate the potential cardiovascular protective effect of thiazolidinediones and the early atherogenic risk factors in patients with type 2 diabetes mellitus.Methods:59 subjects with type 2 diabetes mellitus was selected who previously had no coronary atherosclerotic cardiopathy, and the EKG examination didn't show any myocardial ischemia.High-resolution doppler ultrasonography was applied to measure the carotid intima-media thickness and the atherosclerotic plaque formatin.Record the course of diabetes, measure body height, body weight, blood pressure, FPG, FINS, 2hPG, 2hINS, HbA1c, blood routine examination, blood lipid, hs-CRP was measured in partial subjects. Use the homeostasis model assessment (HOMA) to measure insulin resistance.And calculate the atherogenic index of plasma and body mass index. 59 subjects was administered with rosiglitazone (4mg/d) for three months, and compared with the changes of above indexes pre and post treatment.Results: ① Given rosiglitazone pre and post treatment the levels of IMTmean, IMTmax, IRI, FPG, FINS, 2hPG, 2hINS, HbA1c, SBP, pulse pressure were all showed a significant decrease .②IRI, FINS, SBP and pulse pressure in IMT≥0.85mm group are significantly higher than IMT<0.85mm group, there was higher plague incidence in IMT≥0.85mm group. (3)IMT was positively correlatedwith age^ IRK hs-CRP, SBPn pulse pressure > and 2hPG;IRI was positively correlated withBMK IMT% pulse pressure -. hs-CRP.Conclusions: Insulin resistance > increase of systolic pressure and pulse pressure ^ high level of postprandial glucose, inflammatory reaction are important risk factors of early coronary atherosclerotic lesions in type 2 diabetes mellitus, insulin resistance may be the atherosclerotic basis. Rosiglitazone can reverse early atherosclerosis, which maybe through the effects of decreased insulin resistance and decreased blood pressure.