Effects Of Combined PPARα-Agonist And PPARγ-Agonist On Plasma Levels Of Inflammatory Cytokine In Diabetes Mellitus Patients With Coronary Artery Disease

Objective: This study was designed to observe the effects of combined PPARα-agonist and PPARγ-agonist on plasma levels of inflammatory cytokine in diabetes mellitus patients with coronary artery disease (CAD).Methods: Eighty CAD patients were randomly divided into four groups, rosiglitazone group(n=20), bezafibrate group(n=20),combination of rosiglitazone and bezafibrate group(n=20) and control group(n=20). After treatment, patients were followed-up for 12 weeks. Plasma sample was collected from each patient before and after the treatment, respectively. Then plasma level of C-reactive protein(CRP) and monocyte chemoattractant protein-1(MCP-1) were measured by enzyme-linked immunosorbent assay. At the same time, the changes of fasting plasma glucose (FPG), fasting insulin, insulin resistance index (IRI), hemoglobinA1c(HbA1c),lipid and body mass index level were also investigated.Result: At the end of 12 weeks, patients in combined rosiglitazone and bezafibrate group showed significantly reduction in plasma level of CRP and MCP-1(p<0.05),and FPG ,insulin and IRI,HbA1c,triglycerides also declined and the level of high-density lipoprotein(HDL) cholesterol was higher(p<0.05).All the groups showed no significant change in total cholesterol and low-density lipoprotein(LDL) cholesterol(p>0.05).The decline in plasma levels of CRP appear to be correlated with the disease of insulin(r=0.048,p<0.01) and insulin resistance index(r=0.496,p<0.001),but there was no correlation with other factors.Conclusion: Combination of rosiglitazone and bezafibrate can increase insulin sensitivity ,improve glucose metabolism and reduce the level of CRP,MCP-1 in diabetes mellitus patients with CAD.The effects of combination are more obvious than single drug in inhibing plasma CRP,MCP-1.