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罗格列酮对 2 型糖尿病患者胰岛素敏感性和大腿中段低密度肌肉的影响。

The effect of rosiglitazone on insulin sensitivity and mid-thigh low-density muscle in patients with Type 2 diabetes.

机构信息

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Diabet Med. 2010 Jan;27(1):30-6. doi: 10.1111/j.1464-5491.2009.02897.x.

Abstract

AIMS

We examined the effect of rosiglitazone on insulin sensitivity, abdominal fat and mid-thigh intramuscular fat distribution, and plasma concentrations of adipocytokines in patients with Type 2 diabetes.

METHODS

Rosiglitazone was administered at a daily dose of 4 mg to 42 Type 2 diabetes patients [age 32-70 years, body mass index (BMI) 17.5-32.6 kg/m(2), 15 women, 27 men] for 12 weeks. Various anthropometric and metabolic profiles, plasma adiponectin, leptin, and resistin levels were measured, and insulin resistance was calculated from the short insulin tolerance test. Body fat composition was assessed by computed tomography.

RESULTS

Twelve weeks' rosiglitazone treatment resulted in improved insulin resistance despite increases in body weight and BMI. There was a significant decrease in abdominal visceral adipose tissue area (145 +/- 65.6 vs. 129 +/- 73.1 cm(2), P = 0.049). Mid-thigh low-density muscle area (TLDMA) increased from 23 +/- 9.6 to 26 +/- 8.2 cm(2) (P = 0.009). There were significant changes in plasma adipocytokines, but they were not significantly correlated with changes in insulin resistance.

CONCLUSIONS

Rosiglitazone treatment resulted in an improvement of insulin responsiveness in Type 2 diabetic subjects, which was associated with the redistribution of visceral and subcutaneous adipose tissue, an increase in TLDMA, and changes in serum adipocytokine levels. Further studies are needed to elucidate the insulin sensitizing mechanism of rosiglitazone on peripheral skeletal muscles.

摘要

目的

我们研究了罗格列酮对 2 型糖尿病患者胰岛素敏感性、腹部脂肪和大腿中部肌内脂肪分布以及血浆细胞因子浓度的影响。

方法

42 例 2 型糖尿病患者(年龄 32-70 岁,体重指数 17.5-32.6kg/m²,女性 15 例,男性 27 例)接受罗格列酮(每天 4mg)治疗 12 周。测量各种人体测量和代谢指标,检测血浆脂联素、瘦素和抵抗素水平,并通过短胰岛素耐量试验计算胰岛素抵抗指数。通过计算机断层扫描评估体脂成分。

结果

12 周罗格列酮治疗后,尽管体重和体重指数增加,但胰岛素抵抗得到改善。腹部内脏脂肪组织面积显著减少(145 ± 65.6cm² 比 129 ± 73.1cm²,P = 0.049)。大腿中部低密度肌肉面积(TLDMA)从 23 ± 9.6cm² 增加到 26 ± 8.2cm²(P = 0.009)。血浆细胞因子有显著变化,但与胰岛素抵抗变化无显著相关性。

结论

罗格列酮治疗可改善 2 型糖尿病患者的胰岛素反应性,这与内脏和皮下脂肪组织的重新分布、TLDMA 的增加以及血清细胞因子水平的变化有关。需要进一步研究阐明罗格列酮对周围骨骼肌的胰岛素增敏作用机制。

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