Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS 39216, USA.
Can J Physiol Pharmacol. 2022 Aug 1;100(8):828-833. doi: 10.1139/cjpp-2022-0132. Epub 2022 Jun 3.
Our lab recently reported that the blockade of endothelin-1 (ET-1) receptors attenuates insulin resistance in obese mice; therefore, we hypothesized that patients taking ET-1 receptor antagonists (ERAs) will have improved glycemic control. University of Mississippi Medical Center (2013-2020) electronic health record (EPIC) data were extracted from patients ≥18 years old with a clinical diagnosis of pulmonary hypertension (Food and Drug Administration indication for ERA use) and at least two clinical visits within 2 years. Patients prescribed ERAs ( = 11) were similar in age (61 ± 14 years vs. 60 ± 14 years), body mass index (BMI) (34 ± 8 kg/m vs. 35 ± 11 kg/m), diabetes prevalence (73% vs. 80%, = 0.59), and follow-up time (209 ± 74 days vs. 283 ± 180 days) compared with patients not taking ERAs ( = 137). There was a small but similar decrease in BMI at follow-up in the ERA (-1.9 ± 3 kg/m) and control patients (-1.6 ± 5 kg/m). At follow-up, hemoglobin A1c (HbA1c) significantly decreased -12% ± 11% of baseline in patients taking ERAs, while this did not occur in the control patients (2% ± 20% increase in HbA1c). In the whole population, baseline HbA1c and ERA prescription predicted the fall in HbA1c, while there was no significant association with demographics, diabetes prevalence, and diabetic treatment. These data suggest a potential role of ET-1 in promoting insulin resistance and warrant further investigation into using these drugs for glycemic control.
我们的实验室最近报告称，内皮素-1（ET-1）受体阻断剂可减轻肥胖小鼠的胰岛素抵抗；因此，我们假设服用 ET-1 受体拮抗剂（ERAs）的患者血糖控制将得到改善。从密西西比大学医学中心（2013-2020 年）≥ 18 岁的患有肺动脉高压的患者（ERA 使用的食品和药物管理局适应证）的电子健康记录（EPIC）中提取数据，并且在 2 年内至少有两次就诊。服用 ERA 的患者（n = 11）在年龄（61 ± 14 岁比 60 ± 14 岁）、体重指数（BMI）（34 ± 8 kg/m 比 35 ± 11 kg/m）、糖尿病患病率（73%比 80%，= 0.59）和随访时间（209 ± 74 天比 283 ± 180 天）方面与未服用 ERA 的患者（n = 137）相似。在 ERA 组（-1.9 ± 3 kg/m）和对照组（-1.6 ± 5 kg/m）中，随访时 BMI 均有微小但相似的下降。在服用 ERA 的患者中，HbA1c（基线时的 -12%±11%）显著下降，而对照组患者则未出现这种情况（HbA1c 增加 2%±20%）。在整个人群中，基线 HbA1c 和 ERA 处方可预测 HbA1c 的下降，而与人口统计学、糖尿病患病率和糖尿病治疗无显著相关性。这些数据表明 ET-1 可能在促进胰岛素抵抗中起作用，需要进一步研究这些药物在血糖控制中的作用。
