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尼卡地平不会导致人体血糖稳态恶化:一项针对患有和未患有糖尿病的老年高血压患者的安慰剂对照研究。

Nicardipine does not cause deterioration of glucose homoeostasis in man: a placebo controlled study in elderly hypertensives with and without diabetes mellitus.

作者信息

Giugliano D, Saccomanno F, Paolisso G, Ceriello A, Torella R, Varricchio M, D'Onofrio F

机构信息

Chair of Diabetology and Dietetics, First Faculty of Medicine, University of Naples, Italy.

出版信息

Eur J Clin Pharmacol. 1992;43(1):39-45. doi: 10.1007/BF02280752.

Abstract

The effect of the calcium antagonist nicardipine on insulin secretion and glucose homoeostasis was investigated in elderly hypertensives with and without diabetes mellitus; 15 patients with essential hypertension for at least 10 years and normal glucose tolerance according to standard criteria (Group I) and 15 elderly hypertensive patients affected by Type 2 diabetes mellitus and on treatment with diet or oral drugs (Group 2). In the basal state, all patients were submitted to an oral glucose tolerance test (OGTT, 75 g) and an iv arginine test (30 g), on two different days and in random order. The same tests were repeated after one month of treatment with nicardipine 60 mg/day, in three spaced doses, the last being given 1 h before the post-treatment test. Nicardipine did not change overall glucose homoestasis, as assessed by haemoglobin Alc and fructosamine, nor did it significantly affect the plasma insulin response either to glucose or arginine in Groups 1 and 2. Only the glucagon response to arginine was significantly reduced in diabetic hypertensives. Small, non-significant variations in the metabolic and hormonal parameters were seen in additional two groups of patients (Groups 3 and 4), matched with Groups 1 and 2 for age, sex and diseases, who took capsules containing placebo. Thus, nicardipine did not produce any significant overall alteration in glucose homoestasis when given to elderly diabetic or nondiabetic hypertensive subjects.

摘要

研究了钙拮抗剂尼卡地平对患有和未患糖尿病的老年高血压患者胰岛素分泌及葡萄糖稳态的影响;15例原发性高血压患者,病程至少10年,根据标准标准葡萄糖耐量正常(第1组),以及15例患有2型糖尿病且接受饮食或口服药物治疗的老年高血压患者(第2组)。在基础状态下,所有患者在不同的两天以随机顺序接受口服葡萄糖耐量试验(OGTT,75g)和静脉注射精氨酸试验(30g)。在用尼卡地平60mg/天治疗一个月后,以三个间隔剂量重复相同的试验,最后一剂在治疗后试验前1小时给予。通过糖化血红蛋白和果糖胺评估,尼卡地平并未改变整体葡萄糖稳态,对第1组和第2组中葡萄糖或精氨酸的血浆胰岛素反应也没有显著影响。仅糖尿病高血压患者中对精氨酸的胰高血糖素反应显著降低。另外两组与第1组和第2组年龄、性别和疾病相匹配的患者(第3组和第4组)服用含安慰剂的胶囊,其代谢和激素参数有小的、不显著的变化。因此,给予老年糖尿病或非糖尿病高血压患者时,尼卡地平不会对葡萄糖稳态产生任何显著的整体改变。

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