Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Endocr Pract. 2012 Nov-Dec;18(6):855-63. doi: 10.4158/EP12057.OR.
To determine the effect of a single 8-mg orally administered dose of dexamethasone or placebo on glucose and insulin homeostasis, during an oral glucose tolerance test (OGTT) performed before and 24 hours after the administered dose.
In a randomized, double-blind, placebo-controlled study, we conducted experiments in subjects with normal glucose tolerance (NGT) or prediabetes, all of whom had at least one first-degree relative with type 2 diabetes mellitus. Measures of glucose and insulin homeostasis derived from an OGTT before and 24 hours after administration of dexamethasone or placebo were compared in 21 placebo-treated versus 23 dexamethasone-treated subjects with NGT as well as in 23 placebo-treated versus 20 dexamethasone-treated subjects with prediabetes.
Before administration of dexamethasone or placebo, area under the curve (AUC) for glucose and homeostasis model assessment of insulin resistance were higher, and the Matsuda and disposition indices were lower, in the prediabetic versus the NGT group. In both NGT and prediabetic groups treated with dexamethasone, glucose and insulin values at fasting and during OGTT were increased in comparison with placebo-treated groups at 24 hours (P = .001). Dexamethasone treatment in both study groups increased homeostasis model assessment of insulin resistance and AUC glucose and decreased the Matsuda index (P = .001). No significant changes were observed in AUC insulin/AUC glucose or homeostasis model assessment of beta-cell function after dexamethasone treatment in either the NGT or the prediabetic group. The disposition index decreased and was lowest in the prediabetic group after dexamethasone treatment.
In a study population in which all subjects had at least one first-degree relative with type 2 diabetes mellitus, those with prediabetes were more insulin resistant and had a lower disposition index than did subjects with NGT. Subjects with prediabetes also had a pronounced decrease in disposition index when challenged with a single 8-mg orally administered dose of dexamethasone.
在给予药物前和给予药物后 24 小时进行口服葡萄糖耐量试验（OGTT），观察单次 8mg 口服地塞米松或安慰剂给药对葡萄糖和胰岛素稳态的影响。
在一项随机、双盲、安慰剂对照的研究中，我们对糖耐量正常（NGT）或糖尿病前期患者进行了实验，所有患者均有至少一位 2 型糖尿病的一级亲属。在接受安慰剂治疗的 21 例 NGT 患者和接受地塞米松治疗的 23 例 NGT 患者，以及接受安慰剂治疗的 23 例糖尿病前期患者和接受地塞米松治疗的 20 例糖尿病前期患者中，比较了 OGTT 前和给予地塞米松或安慰剂后 24 小时的葡萄糖和胰岛素稳态指标。
在给予地塞米松或安慰剂前，与 NGT 组相比，糖尿病前期组的葡萄糖曲线下面积（AUC）和胰岛素抵抗稳态模型评估值较高，而 Matsuda 指数和处置指数较低。与安慰剂治疗组相比，接受地塞米松治疗的 NGT 和糖尿病前期组患者，24 小时时空腹和 OGTT 时的血糖和胰岛素值均升高（P =.001）。在两个研究组中，地塞米松治疗均增加了胰岛素抵抗稳态模型评估值和 AUC 葡萄糖，降低了 Matsuda 指数（P =.001）。与 NGT 组或糖尿病前期组接受地塞米松治疗后相比，胰岛素 AUC/AUC 葡萄糖或胰岛素β细胞功能稳态模型评估值均无显著变化。接受地塞米松治疗后，NGT 组和糖尿病前期组的处置指数均下降，糖尿病前期组最低。
在所有患者均有至少一位 2 型糖尿病一级亲属的研究人群中，与 NGT 组相比，糖尿病前期患者的胰岛素抵抗更严重，且处置指数更低。与 NGT 患者相比，糖尿病前期患者在接受单次 8mg 口服地塞米松剂量挑战时，其处置指数明显下降。
