Metabolic syndrome treatment: focusing on acarbose
Aim. To compare the effectiveness of alpha-glucosidase inhibitor acarbose (150 or 300 mg/d) and non-pharmaceutical lifestyle modification in controlling arterial hypertension (AH), carbohydrate and lipid metabolism, and body weight (BW) among patients with impaired glucose tolerance (IGT) and AH. Material and methods. The study included 380 patients with Stage I-II AH, abdominal obesity (АО), and IGT. All participants were randomized into three equal groups: two groups receiving acarbose (150 or 300 mg/d) and a control group. At baseline and after 24 weeks of the treatment, anthropometry, carbohydrate and lipid metabolism parameters, as well as 24-hour blood pressure (BP) monitoring data were assessed. Results. In participants receiving acarbose, BW reduction was twice as effective as in the controls. In all groups, the levels of fasting and especially postprandial glucose, total cholesterol (CH), and triglycerides were significantly reduced. Substantial reduction of low-density lipoprotein CH was observed only in those receiving 300 mg/d of acarbose, and high-density lipoprotein cholesterol level increased significantly only in patients receiving 150 mg/d ofacarbose. In both acarbose groups, systolic and diastolic BP(SBP, DBP) reduction was significantly greater than in the control group. Target fasting and postprandial glucose levels were achieved in most individuals receiving acarbose, in contrast to the controls. More than 80% of those from both acarbose groups achieved target SBP and DBP levels. Conclusion. In patients with metabolic syndrome, acarbose therapy decreased BW, АО, ВР, fasting and postprandial glucose levels, at the same time improving lipid profile.