State Institute of Diabetes and Endocrinology, IEDE, Rio de Janeiro, Brazil.
Diabet Med. 2010 Jan;27(1):23-9. doi: 10.1111/j.1464-5491.2009.02868.x.
Insulin resistance is intrinsically related to intramyocellular (IMCL) rather than extramyocellular (EMCL) triglyceride content. Conflicting results have been reported on the ability of insulin sensitizer agents, such as thiazolidinediones, to modify muscle fat distribution. The aim of this study was to investigate the role of rosiglitazone on muscle fat compartment distribution in an adult population of obese non-diabetic metabolic syndrome patients.
Fifteen obese, non-diabetic, metabolic syndrome patients were studied by means of proton nuclear magnetic resonance ((1)H-NMR) spectroscopy before and after treatment with rosiglitazone 8 mg/day for 6 months. Anthropometrical and metabolic variables were assessed.
After rosiglitazone, body weight and hip circumference increased [100.9 (91.12-138.7) vs. 107.0 (79.6-142.8) kg and 118 (107-126) vs. 122 (110-131) cm]; while waist-hip ratio (WHR) decreased from 0.93 (0.87-1.00) to 0.89 (0.82-0.97) (P < 0.001 for all). Additionally, fasting plasma glucose, insulin and homeostatis model assessment of insulin resistance (HOMA-IR) significantly decreased while adiponectin increased over threefold [9.7 (3.7-17.7) vs. 38.0 (19.3-42.4) microg/ml] without any changes in resistin. Finally, the IMCL did not change [267.54 (213.94-297.94) vs. 305.75 (230.80-424.75) arbitrary units (AU), P = 0.15] while the EMCL increased [275.53 (210.39-436.66) vs. 411.39 (279.92-556.59) AU; P < 0.01] therefore decreasing the IMCL-to-EMCL (IMCL/EMCL) ratio [1.07 (0.78-1.23) vs. 0.71 (0.53-0.96); P < 0.01].
Rosiglitazone treatment increased body weight and hip circumference and decreased WHR. More importantly, it decreased the IMCL/EMCL ratio by increasing the EMCL without any significant change on the IMCL.
胰岛素抵抗与肌内（IMCL）而非肌外（EMCL）甘油三酯含量密切相关。有报道称，胰岛素增敏剂如噻唑烷二酮类药物能够改变肌肉脂肪分布，但结果存在冲突。本研究旨在探讨罗格列酮对肥胖非糖尿病代谢综合征患者肌肉脂肪分布的作用。
采用质子磁共振波谱((1)H-NMR)技术，对 15 例肥胖、非糖尿病、代谢综合征患者进行检测，在接受罗格列酮 8mg/天治疗 6 个月前后进行分析。评估患者的人体测量学和代谢变量。
罗格列酮治疗后，体重和臀围增加[100.9（91.12-138.7）vs. 107.0（79.6-142.8）kg 和 118（107-126）vs. 122（110-131）cm]；而腰围-臀围比（WHR）从 0.93（0.87-1.00）降至 0.89（0.82-0.97）（均 P < 0.001）。此外，空腹血糖、胰岛素和稳态模型评估的胰岛素抵抗（HOMA-IR）显著降低，脂联素增加三倍以上[9.7（3.7-17.7）vs. 38.0（19.3-42.4）μg/ml]，而抵抗素无变化。最后，肌内甘油三酯（IMCL）没有变化[267.54（213.94-297.94）vs. 305.75（230.80-424.75）任意单位（AU），P = 0.15]，而肌外甘油三酯（EMCL）增加[275.53（210.39-436.66）vs. 411.39（279.92-556.59）AU；P < 0.01]，因此 IMCL/EMCL 比值降低[1.07（0.78-1.23）vs. 0.71（0.53-0.96）；P < 0.01]。
罗格列酮治疗可增加体重和臀围，降低 WHR。更重要的是，它通过增加 EMCL 而不显著改变 IMCL，降低了 IMCL/EMCL 比值。
