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硝苯地平对非胰岛素依赖型糖尿病患者碳水化合物代谢的影响

[Effects of nifedipine on carbohydrate metabolism in the non-insulin dependent diabetic].

作者信息

Abadie E, Villette J M, Gauville C, Tabuteau F, Fiet J, Passa P

出版信息

Diabete Metab. 1985 Jun;11(3):141-6.

PMID:3896885
Abstract

The aim of this prospective, randomized, double-blind, placebo controlled study was to investigate the effect of nifedipine on carbohydrate metabolism in diabetic patients after a 3-day and a 3-month course of treatment. Sixteen non obese, well controlled non-insulin dependent diabetics, (HbA1 less than 10%), with moderate untreated hypertension were divided in two groups: nifedipine (group N, 8 patients) and placebo (group P, 8 patients). An oral glucose tolerance test (OGTT, 75 g glucose) and an arginine infusion were performed before, after a 3-day, and a 3-month course, either of nifedipine 30 mg/D or placebo. Blood samples obtained during OGTT were assayed for glucose and insulin, and during arginine infusion for insulin, glucagon and growth hormone. The differences between basal and peak values during tests were compared between both groups before and after treatment using Wilcoxon's rank sum test. Neither acute nor chronic administration of nifedipine or placebo modified the glucose tolerance. However, basal insulin levels were reduced by 3 month-administration of nifedipine (from 19 +/- 2 micromicrons/ml to 10 +/- 1 micromicrons/ml, p = 0,01). Otherwise the basal and peak hormonal values during tests were not significantly affected by nifedipine either at the start of after 3 months of treatment. These results suggest that nifedipine, when given in standard dosage for 3 months, has minor effects on carbohydrate metabolism in non-insulin dependent diabetic patients.

摘要

这项前瞻性、随机、双盲、安慰剂对照研究的目的是,调查硝苯地平在为期3天和3个月的疗程后对糖尿病患者碳水化合物代谢的影响。16名非肥胖、病情得到良好控制的非胰岛素依赖型糖尿病患者(糖化血红蛋白低于10%),伴有中度未经治疗的高血压,被分为两组:硝苯地平组(N组,8名患者)和安慰剂组(P组,8名患者)。在服用30毫克/天硝苯地平或安慰剂的3天及3个月疗程前后,进行口服葡萄糖耐量试验(OGTT,75克葡萄糖)和精氨酸输注。在OGTT期间采集的血样检测葡萄糖和胰岛素,在精氨酸输注期间检测胰岛素、胰高血糖素和生长激素。使用威尔科克森秩和检验比较两组治疗前后测试期间基础值和峰值之间的差异。硝苯地平或安慰剂的急性或慢性给药均未改变葡萄糖耐量。然而,硝苯地平治疗3个月后基础胰岛素水平降低(从19±2微单位/毫升降至10±1微单位/毫升,p=0.01)。此外,治疗3个月开始时或之后,硝苯地平对测试期间的基础和峰值激素值均无显著影响。这些结果表明,硝苯地平以标准剂量给药3个月时,对非胰岛素依赖型糖尿病患者的碳水化合物代谢影响较小。

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