Lee Grace A, Rao Madhu, Mulligan Kathleen, Lo Joan C, Aweeka Francesca, Schwarz Jean-Marc, Schambelan Morris, Grunfeld Carl
Department of Medicine, University of California, San Francisco, California, USA.
AIDS. 2007 Oct 18;21(16):2183-90. doi: 10.1097/QAD.0b013e32826fbc54.
Some HIV protease inhibitors (PIs) have been shown to induce insulin resistance in vitro but the degree to which specific PIs affect insulin sensitivity in humans is less well understood.
In two separate double-blind, randomized, cross-over studies, we assessed the effects of a single dose of ritonavir (800 mg) and amprenavir (1200 mg) on insulin sensitivity (euglycemic hyperglycemic clamp) in healthy normal volunteers.
Ritonavir decreased insulin sensitivity (-15%; P = 0.008 versus placebo) and non-oxidative glucose disposal (-30%; P = 0.0004), whereas neither were affected by amprenavir administration.
Compared to previously performed studies of identical design using single doses of indinavir and lopinavir/ritonavir, a hierarchy of insulin resistance was observed with the greatest effect seen with indinavir followed by ritonavir and lopinavir/ritonavir, with little effect of amprenavir.
一些HIV蛋白酶抑制剂（PIs）在体外已被证明可诱导胰岛素抵抗，但特定PIs对人体胰岛素敏感性的影响程度尚不太清楚。
在两项独立的双盲、随机、交叉研究中，我们评估了单剂量利托那韦（800毫克）和安普那韦（1200毫克）对健康正常志愿者胰岛素敏感性（正常血糖高血糖钳夹法）的影响。
利托那韦降低了胰岛素敏感性（-15%；与安慰剂相比，P = 0.008）和非氧化葡萄糖处置能力（-30%；P = 0.0004），而安普那韦给药对两者均无影响。
与先前使用单剂量茚地那韦和洛匹那韦/利托那韦进行的相同设计研究相比，观察到胰岛素抵抗存在等级差异，茚地那韦的影响最大，其次是利托那韦和洛匹那韦/利托那韦，安普那韦的影响很小。
