Whitelaw D C, Smith J M, Nattrass M
Diabetes Resource Centre and Department of Clinical Biochemistry, University Hospitals Birmingham, UK.
Diabetes Obes Metab. 2002 May;4(3):187-94. doi: 10.1046/j.1463-1326.2002.00199.x.
To examine whether lowering of plasma triglyceride concentrations using the fibrate peroxisome proliferator-activated receptor (PPAR)alpha agonist gemfibrozil would influence insulin sensitivity to various aspects of intermediary metabolism among subjects with type 2 diabetes mellitus.
A randomized placebo-controlled double-blind study in 12 subjects with type 2 diabetes were treated for 12 weeks after a 12-week dietary run-in. Insulin sensitivity was assessed using a low-dose incremental intravenous insulin infusion.
Gemfibrozil significantly reduced fasting serum triglyceride concentrations (p < 0.001) but had no effect on measures of diabetic control. Neither gemfibrozil nor placebo treatment altered insulin sensitivity of glucose or glycerol metabolism during low-dose insulin infusion, but significant falls in both non-esterified fatty acid (NEFA) (p = 0.003) and ketone concentrations (p = 0.002) were observed after treatment with gemfibrozil.
Gemfibrozil does not affect insulin sensitivity to glucose or fat metabolism in type 2 diabetes but enhances the lowering of plasma NEFA concentrations by insulin, probably by reducing hepatic fatty acid synthesis.
研究使用贝特类过氧化物酶体增殖物激活受体（PPAR）α激动剂吉非贝齐降低血浆甘油三酯浓度是否会影响2型糖尿病患者对中间代谢各方面的胰岛素敏感性。
一项随机、安慰剂对照、双盲研究，12名2型糖尿病患者在经过12周饮食导入期后接受治疗12周。使用低剂量递增静脉胰岛素输注评估胰岛素敏感性。
吉非贝齐显著降低空腹血清甘油三酯浓度（p<0.001），但对糖尿病控制指标无影响。在低剂量胰岛素输注期间，吉非贝齐和安慰剂治疗均未改变葡萄糖或甘油代谢的胰岛素敏感性，但在吉非贝齐治疗后，游离脂肪酸（NEFA）（p = 0.003）和酮浓度（p = 0.002）均显著下降。
吉非贝齐不影响2型糖尿病患者对葡萄糖或脂肪代谢的胰岛素敏感性，但可能通过减少肝脏脂肪酸合成增强胰岛素对血浆NEFA浓度的降低作用。
