Kruszynska Y T, Greenstone M, Home P D, Cooke N J
Department of Respiratory Medicine, Leeds General Infirmary.
Thorax. 1987 Nov;42(11):881-4. doi: 10.1136/thx.42.11.881.
The metabolic effects of four weeks' high dose inhaled beclomethasone dipropionate (500 micrograms twice daily) were studied in nine normal subjects with an open study design. No effect was found on fasting blood glucose concentration or glycosylated haemoglobin concentration. Peak blood glucose concentration 30 minutes after a 75 g oral glucose load was, however, significantly higher (7.1 (SEM 0.2) versus 6.7 (0.1) mmol/l, or 128 (3.6) v 121 (1.8) mg/100 ml). After treatment there was a 36% increase in fasting serum insulin concentration (7.6 (0.7) versus 5.6 (0.5) mU/l) and a 32% increase in the area under the serum insulin concentration curve after glucose challenge. High dose inhaled beclomethasone dipropionate treatment raised the fasting plasma cholesterol concentration (4.62 (0.25) v 4.16 (0.26) mmol/l, or 178 (9.7) v 161 (10.0) mg/100 ml) and high density lipoprotein cholesterol (1.19 (0.065) versus 0.97 (0.065) mmol/l, or 45 (2.5) v 37 (2.5) mg/100 ml). Fasting blood lactate and pyruvate concentrations were also significantly higher and blood glycerol lower. The findings indicate that high dose inhaled beclomethasone dipropionate may disturb both carbohydrate and lipid metabolism.
采用开放研究设计，对9名正常受试者进行了为期四周的高剂量吸入丙酸倍氯米松（每日两次，每次500微克）代谢效应的研究。未发现对空腹血糖浓度或糖化血红蛋白浓度有影响。然而，口服75克葡萄糖负荷后30分钟的血糖峰值浓度显著更高（分别为7.1（标准误0.2）与6.7（0.1）毫摩尔/升，或128（3.6）与121（1.8）毫克/100毫升）。治疗后，空腹血清胰岛素浓度增加了36%（分别为7.6（0.7）与5.6（0.5）毫单位/升），葡萄糖激发后血清胰岛素浓度曲线下面积增加了32%。高剂量吸入丙酸倍氯米松治疗使空腹血浆胆固醇浓度升高（分别为4.62（0.25）与4.16（0.26）毫摩尔/升，或178（9.7）与161（10.0）毫克/100毫升）以及高密度脂蛋白胆固醇升高（分别为1.19（0.065）与0.97（0.065）毫摩尔/升，或45（2.5）与37（2.5）毫克/100毫升）。空腹血乳酸和丙酮酸浓度也显著更高，而血甘油更低。这些发现表明，高剂量吸入丙酸倍氯米松可能会干扰碳水化合物和脂质代谢。
