Gómez-Pérez Francisco J, Aguilar-Salinas Carlos A, Vázquez-Chávez Cuauhtémoc, Fanghänel-Salmón Guillermo, Gallegos-Martínez José, Gómez-Diaz Rita A, Salinas-Orozco Saul, Chavira-López Ismael J, Sánchez-Reyes Leticia, Torres-Acosta Evelyn M, Tamez Ricardo, López Angelina, Guillén Luz E, Cesarman Gabriela
Department of Endocrinology and Metabolism and Hematology, Instituto Nacional de la Nutrición "Salvador Zubirán," México City, Mexico.
Metabolism. 2002 Jan;51(1):44-51. doi: 10.1053/meta.2002.29024.
The effects of troglitazone 400 or 600 mg/d on the glycemic control, very-low-density lipoprotein (VLDL), and high-density lipoprotein (HDL) subclass concentrations and plasminogen-activator inhibitor 1 (PAI-1) levels were assessed in patients with type 2 diabetes that had not been controlled with dietary treatment. This was a multicenter, open-label, parallel-groups study. It included a run-in 4-week diet period and a 24-week randomized treatment. Fifty one patients received 400 mg/d and 55 patients 600 mg. The mean HbA(1c) concentration at the end of the study was similar for both doses. Troglitazone, regardless of dose, significantly improved insulin sensitivity assessed by the homeostasis model (HOMA). PAI-1 levels were significantly decreased in both groups by 13%. Higher HDL cholesterol concentrations and lower triglycerides levels were observed at the end of treatment. Triglyceride contents were reduced only in the lighter VLDL1. The change in HDL cholesterol concentration resulted from a combination of increased HDL3 cholesterol and lower HDL2 cholesterol levels. No differences were found in the effects of both treatment groups on the evaluated parameters. Our data provide new information about the actions of the drug on the lipid profile. Troglitazone reduces triglyceride levels by lowering the triglycerides content of the VLDL1 particles and increases HDL cholesterol concentrations by increasing HDL3 cholesterol levels.
在未通过饮食治疗控制病情的2型糖尿病患者中，评估了每日400毫克或600毫克曲格列酮对血糖控制、极低密度脂蛋白（VLDL）、高密度脂蛋白（HDL）亚类浓度以及纤溶酶原激活物抑制剂1（PAI-1）水平的影响。这是一项多中心、开放标签、平行组研究。研究包括为期4周的饮食导入期和为期24周的随机治疗期。51名患者接受每日400毫克的剂量，55名患者接受600毫克的剂量。研究结束时，两种剂量的平均糖化血红蛋白（HbA1c）浓度相似。无论剂量如何，曲格列酮均通过稳态模型（HOMA）显著改善胰岛素敏感性。两组的PAI-1水平均显著降低了13%。治疗结束时观察到较高的高密度脂蛋白胆固醇浓度和较低的甘油三酯水平。甘油三酯含量仅在较轻的VLDL1中有所降低。高密度脂蛋白胆固醇浓度的变化是由于HDL3胆固醇增加和HDL2胆固醇水平降低共同作用的结果。两个治疗组在评估参数上的效果未发现差异。我们的数据提供了有关该药物对脂质谱作用的新信息。曲格列酮通过降低VLDL1颗粒的甘油三酯含量来降低甘油三酯水平，并通过提高HDL3胆固醇水平来增加高密度脂蛋白胆固醇浓度。
