Bennett S M A, Agrawal A, Elasha H, Heise M, Jones N P, Walker M, Wilding J P H
Department of Diabetes & Metabolism, Diabetes Resource Centre, University of Newcastle, North Tyneside General Hospital, Rake Lane, North Shields, Tyne & Wear NE29 8NH, Newcastle upon Tyne, UK.
Diabet Med. 2004 May;21(5):415-22. doi: 10.1111/j.1464-5491.2004.01155.x.
To determine the effects of rosiglitazone on insulin sensitivity, glucose tolerance and ambulatory blood pressure when administered to subjects with persistent impaired glucose tolerance (IGT).
Eighteen subjects with persistent IGT were randomized to receive rosiglitazone 4 mg twice daily or matching placebo for 12 weeks. Evaluation at baseline and at the end of treatment included measurement of whole body insulin sensitivity during a euglycaemic hyperinsulinaemic clamp and deriving an insulin sensitivity index. Changes in glucose and insulin concentration were determined after oral glucose tolerance test (OGTT) and mixed meal tolerance tests, and 24-h ambulatory blood pressure was monitored.
Rosiglitazone significantly improved the insulin sensitivity index by 2.26 micro g/kg per min per pmol/l relative to placebo (P = 0.0003). Four of nine subjects receiving rosiglitazone reverted to normal glucose tolerance and 5/9 remained IGT, although four of these had improved 2-h glucose values. In the placebo group, 1/9 subjects progressed to Type 2 diabetes and 8/9 remained IGT. Following OGTT and meal tolerance test, glucose and insulin area under curve were reduced over 3 and 4 h, respectively. Compared with placebo, ambulatory blood pressure decreased significantly in the rosiglitazone group by 10 mmHg systolic (P = 0.0066) and 8 mmHg diastolic (P = 0.0126).
Consistent with its effects in patients with Type 2 diabetes, rosiglitazone substantially improved whole body insulin sensitivity and the glycaemic and insulinaemic responses to an OGTT and meal tolerance test in subjects with persistent IGT. Furthermore, rosiglitazone reduced systolic and diastolic ambulatory blood pressure in these subjects.
确定罗格列酮对持续性糖耐量受损（IGT）受试者胰岛素敏感性、葡萄糖耐量和动态血压的影响。
18名持续性IGT受试者被随机分为两组，分别接受每日两次4毫克罗格列酮或匹配的安慰剂治疗，为期12周。在基线和治疗结束时进行评估，包括在正常血糖高胰岛素钳夹期间测量全身胰岛素敏感性并得出胰岛素敏感性指数。在口服葡萄糖耐量试验（OGTT）和混合餐耐量试验后测定葡萄糖和胰岛素浓度的变化，并监测24小时动态血压。
与安慰剂相比，罗格列酮使胰岛素敏感性指数显著提高，每微摩尔/升每分钟每千克体重增加2.26微克（P = 0.0003）。接受罗格列酮治疗的9名受试者中有4名恢复到正常糖耐量，5/9仍为IGT，尽管其中4人的2小时血糖值有所改善。在安慰剂组中，1/9的受试者进展为2型糖尿病，8/9仍为IGT。在OGTT和餐耐量试验后，葡萄糖和胰岛素曲线下面积在3小时和4小时内分别降低。与安慰剂相比，罗格列酮组的动态血压显著下降，收缩压下降了10 mmHg（P = 0.0066），舒张压下降了8 mmHg（P = 0.0126）。
与对2型糖尿病患者的作用一致，罗格列酮显著改善了持续性IGT受试者的全身胰岛素敏感性以及对OGTT和餐耐量试验的血糖和胰岛素反应。此外，罗格列酮降低了这些受试者的收缩压和舒张压。
