INFLUENCE OF ACARBOSE ON POSTPRANDIAL DYSMETABOLISM: RESULTS OF AN OPEN-LABEL RANDOMIZED STUDY

Aim. To evaluate postprandial changes of lipid and glucose profiles, inflammation markers levels and flow-mediated vasodilatation in patients with metabolic syndrome (MS) and to estimate acarbose course treatment efficacy in glucose intolerant patients.
Material and methods. A total of 114 MS patients (83 men, 31 women) were examined, MS was associated with impaired glucose tolerance (IGT) in 55 cases. At the first stage postpran- dial dynamics of flow-mediated dilation (FMD), lipid profile parameters, inflammation markers and insulin levels were estimated. At the second stage patients with MS and IGT (n=55) were randomly assigned to the two groups of treatment. Patients of the first group (n=28) had non-drug treatment. Patients of the second group (n=27) received acarbose 300 mg/day for 3 months in addition to recommendations for lifestyle change. 3 months later postprandial values of lipid and glucose profiles parameters, inflammation markers levels and FMD were reassessed. Results. MS patients with IGT revealed maximal disorders in metabolic parameters during postprandial period: increase in the plasma levels of total cholesterol by 6.1%, high density lipoproteins – by 1.7%, and triglycerides – by 27.87%, increase in atherogenic index by 4.8%, and plasma concentrations of glucose – by 54.7%, insulin – by 30.2%, HOMA index – by 73.3%, as well as concentrations of C-reactive protein (CRP) – by 49.7%, tumor necrose factor alpha – by 20.8%, and interleukin-6 (IL-6) – by 51.9%. FMD decreased by 34.3%.
After 12 weeks of the acarbose treatment we had revealed positive dynamics of studied indices in postprandial period as compared to an only non-drug management: levels of glucose in- creased by 24.1% vs 44.4%, insulin – by 14.4% vs 24.4%, CRP – by 19.9% vs 36.6%, IL-6 – by 25.1% vs 41.7%; postprandial FMD decreased by 18.9% vs 31.1%.
Conclusion. Prescription of acarbose 300 mg/day for 12 weeks in glucose intolerant patients is characterized by less significant postprandial increase in insulin resistance, inflammation mark- ers (CRP and IL-6) levels, less decrease in flow-mediated vasodilatation with no influence on lipid metabolism parameters.

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