puerarin

Aims: To assess the effect (week 12/week 24) of puerarin on carotid intima-media thickness (CIMT) in rheumatoid arthritis (RA). Methods: In the open, controlled, randomized and parallel-group comparison study, 119 consecutive RA patients under routine antirheumatic care were randomized to receive treatment either with (n = 60, 16 males and 44 females; mean age: 52.97 years, 95% CI 49.78 to 56.15) or without (n = 59, 17 males and 42 females, mean age: 54.05 years, 95% CI 50.03 to 58.07) 400 mg puerarin. The effect of both interventions on carotid intima-media thickness (CIMT) and homeostasis model assessment of insulin resistance (HOMA-IR) value were compared at entry, 12 and 24 weeks. Results: No significant side effects occurred concerning the use of puerarin, and both interventions were generally well tolerated in all the patients. Tiny but significant decrease of CIMT was observed in puerarin-treated patients at 24 weeks (-0.003 mm, 95% CI -0.005 to -0.001 vs. 0.019 mm, 95% CI -0.002 to 0.040, p&lt;0.001). At 24 weeks, insulin resistance was indicated with more pronounced improvement in puerarin group vs. control (homeostasis model assessment, -0.40, 95% CI -0.47 to -0.33 vs. -0.05, 95% CI -0.08 to -0.01 p &lt; 0.001). Correlation analysis indicated an interaction between the parallel reductions in CIMT and insulin resistance in puerarin group (r = 0.878, p &lt; 0.001), but not in control. Conclusion: In the study, 24 weeks of treatment with 400 mg puerarin exerted significant effect on preventing CIMT progression in active RA patients, which may be associated with the improvement of insulin resistance. Puerarin holds promise as a drug candidate for the prevention and treatment of cardiometabolic comorbidities in RA patients.研究目的：评估葛根素（puerarin）对类风湿关节炎（rheumatoid arthritis, RA）患者颈动脉内膜中层厚度（carotid intima-media thickness, CIMT）的影响（第12周/第24周）。 方法：本研究为开放、对照、随机平行分组试验，将119例接受常规抗风湿治疗的连续性类风湿关节炎患者随机分为两组：试验组（n=60，男16例、女44例；平均年龄52.97岁，95%置信区间49.78~56.15）给予400mg葛根素治疗，对照组（n=59，男17例、女42例；平均年龄54.05岁，95%置信区间50.03~58.07）不给予葛根素治疗。分别于入组时、治疗12周及24周时，比较两种干预方案对颈动脉内膜中层厚度（CIMT）及胰岛素抵抗稳态模型评估（homeostasis model assessment of insulin resistance, HOMA-IR）指标的影响。 结果：葛根素用药期间未出现显著不良反应，所有患者对两种干预方案均耐受良好。治疗24周时，试验组患者的CIMT出现微小但具有统计学意义的降低（较基线变化值为-0.003mm，95%置信区间-0.005~-0.001；对照组为0.019mm，95%置信区间-0.002~0.040，p<0.001）。治疗24周时，试验组的胰岛素抵抗改善更为显著：稳态模型评估指标变化值为-0.40，95%置信区间-0.47~-0.33；对照组为-0.05，95%置信区间-0.08~-0.01，p<0.001。相关性分析显示，试验组患者的CIMT与胰岛素抵抗呈平行降低的相关性（r=0.878，p<0.001），而对照组未观察到该相关性。 结论：本研究显示，对活动性类风湿关节炎患者给予400mg葛根素治疗24周，可显著延缓颈动脉内膜中层厚度进展，该作用可能与改善胰岛素抵抗相关。葛根素有望成为类风湿关节炎患者心血管代谢共病的防治候选药物。