Ferrari P, Giachino D, Weidmann P, Shaw S, Riesen W, Neuner N, Keller U, Heynen G
Medizinische Poliklinik, University of Berne, Switzerland.
Eur J Clin Pharmacol. 1991;41(2):109-13. doi: 10.1007/BF00265901.
The sensitivity of peripheral tissues to insulin is of pathophysiological, therapeutic and possibly also of prognostic relevance. Calcium channel blockers are widely used in the treatment of cardiovascular disorders that are commonly associated with decreased insulin sensitivity (SI). To evaluate the effects of calcium channel blokkade on SI, glucose homoeostasis and lipid profiles, studies were made of SI (determined by the Minimal Model Method of Bergman), basal glucose and insulin levels, serum total triglyceride (Tg) and lipoprotein cholesterol (C) fractions and certain other variables in 38 healthy young men (24 y) during placebo and after 3 weeks of calcium channel blockade with amlodipine 5 mg once daily. Measurements were made after 3 days on a standard diet (2200 kcal.day-1, 45% carbohydrates, 40% fat and 15% proteins) and after an overnight fast. Compared to placebo, amlodipine decreased supine systolic blood pressure (P less than 0.01). Heart rate, body weight and 24 h urinary sodium excretion were unaltered, and so were fasting plasma glucose (placebo vs amlodipine: 4.86 vs 4.83 mmol.l-1, respectively) and insulin levels (7.7 vs 7.9 microU.ml-1), SI (10.5 vs 9.6.10(-4) x min-1 pro microU.ml-1), serum total Tg, C and lipoprotein C fractions. The findings demonstrate unchanged insulin sensitivity and secretion, as well as lipoprotein regulation, during maintenance administration of 5 mg amlodipine daily to healthy young men.
外周组织对胰岛素的敏感性具有病理生理学、治疗学以及可能的预后相关性。钙通道阻滞剂广泛用于治疗通常与胰岛素敏感性(SI)降低相关的心血管疾病。为了评估钙通道阻滞对SI、葡萄糖稳态和血脂谱的影响,对38名健康年轻男性(24岁)在服用安慰剂期间以及每日一次服用5毫克氨氯地平进行3周钙通道阻滞后的SI(由伯格曼最小模型法测定)、基础血糖和胰岛素水平、血清总甘油三酯(Tg)和脂蛋白胆固醇(C)组分以及某些其他变量进行了研究。在标准饮食(2200千卡/天,45%碳水化合物,40%脂肪和15%蛋白质)3天后以及过夜禁食后进行测量。与安慰剂相比,氨氯地平降低了仰卧位收缩压(P小于0.01)。心率、体重和24小时尿钠排泄未改变,空腹血糖(安慰剂与氨氯地平:分别为4.86与4.83毫摩尔/升)和胰岛素水平(7.7与7.9微单位/毫升)、SI(10.5与9.6×10⁻⁴×分钟⁻¹/微单位/毫升)、血清总Tg、C和脂蛋白C组分也未改变。研究结果表明,对健康年轻男性每日维持服用5毫克氨氯地平期间,胰岛素敏感性和分泌以及脂蛋白调节未发生变化。