Department of Medicine, University of California, San Francisco, CA, USA.
J Acquir Immune Defic Syndr. 2009 Oct 1;52(2):246-8. doi: 10.1097/QAI.0b013e3181b03214.
The effects of different HIV protease inhibitors (PIs) on peripheral insulin resistance have been described, but less is known about their effects on insulin suppression of endogenous glucose production (EGP).
We tested the acute effects of 3 PIs, indinavir, ritonavir, and amprenavir, on EGP quantified by stable isotope techniques during the hyperinsulinemic, euglycemic clamp in 3 similar placebo-controlled protocols.
EGP was higher with indinavir in the hyperinsulinemic state than with placebo (4.1 +/- 1.3 vs. 2.2 +/- 0.8 microg x kg(-1) x min(-1), P = 0.04). A trend toward higher EGP was seen with ritonavir (3.6 +/- 0.3 vs. 3.0 +/- 0.5 microg x kg(-1) x min(-1), P = 0.08). There was no evidence that amprenavir blunted insulin suppression of EGP compared with placebo (2.9 +/- 0.04 vs. 3.2 +/- 0.7 microg x kg(-1) x min(-1), P = 0.63).
Some PIs can acutely blunt the ability of insulin to suppress EGP, but, as with insulin resistance, the effects of PIs on EGP are drug-specific, not class-specific.
不同的 HIV 蛋白酶抑制剂（PI）对周围胰岛素抵抗的影响已有描述，但对于它们对胰岛素抑制内源性葡萄糖生成（EGP）的影响知之甚少。
我们在 3 项类似的安慰剂对照方案中，通过稳定同位素技术测试了 3 种 PI（茚地那韦、利托那韦和安普那韦）在高胰岛素、正常血糖钳夹试验中对 EGP 的急性影响。
与安慰剂相比，在高胰岛素状态下，EGP 更高（4.1 +/- 1.3 vs. 2.2 +/- 0.8 microg x kg(-1) x min(-1)，P = 0.04）。利托那韦也显示出更高的 EGP 趋势（3.6 +/- 0.3 vs. 3.0 +/- 0.5 microg x kg(-1) x min(-1)，P = 0.08）。没有证据表明安普那韦与安慰剂相比削弱了胰岛素对 EGP 的抑制作用（2.9 +/- 0.04 vs. 3.2 +/- 0.7 microg x kg(-1) x min(-1)，P = 0.63）。
一些 PI 可以急性削弱胰岛素抑制 EGP 的能力，但与胰岛素抵抗一样，PI 对 EGP 的影响是药物特异性的，而不是药物类别的。
