Abstract: Objective To investigate the effects of alpha-glucosidase inhibitor, acarbose, on YKL-40 and gut bacteria in coronary heart disease(CHD)patients with impaired glucose tolerance(IGT). Methods A total of 57 CHD patients with IGT were randomly divided into the control group(group A, n=27)and 300 mg/d acarbose intervention group(group B, n=30). At the baseline and 24-week end point, anthropometrical parameters, fast blood glucose(FBG), 2 h postprandial blood glucose(PBG), serum fast insulin(FINS), lipid profile, HbA1c and serum YKL-40 were measured. The quantification of fecal Bifidobacterium and Lactobacillus faecalis were detected with RT-PCR. Results There were no significant differences between the two groups in terms of the physical and hematological parameters at baseline. Pearson correlation analysis showed that levels of Bifidobacterium and Lactobacillus were negatively correlated with YKL-40. After 24-week acarbose(300 mg/d)treatment, the levels of YKL-40, FBG, PBG, HbA1c and HOMA-IR significantly decreased in group B(P<0.05), while the levels of Bifidobacterium and Lactobacillus significantly increased in group B(P<0.05). Conclusion After 24-week treatment with 300 mg/d acarbose, CHD patients with IGT have improved glucose metabolism, decreased YKL-40 level, but increased number of beneficial gut microbiota.

Key words: Acarbose, Coronary heart disease, Impaired glucose tolerance, YKL-40, Gut bacteria