氟西汀可改善非胰岛素依赖型糖尿病肥胖患者的胰岛素敏感性，且与体重减轻无关。

Fluoxetine improves insulin sensitivity in obese patients with non-insulin-dependent diabetes mellitus independently of weight loss.

作者信息

Maheux P, Ducros F, Bourque J, Garon J, Chiasson J L

机构信息

Clinical Research Institute of Montreal, Department of Medicine, Faculty of Medicine, University of Montreal, Canada.

出版信息

Int J Obes Relat Metab Disord. 1997 Feb;21(2):97-102. doi: 10.1038/sj.ijo.0800372.

DOI:10.1038/sj.ijo.0800372

PMID:9043962

Abstract

OBJECTIVE

To study the effect of fluoxetine, a specific serotonin reuptake inhibitor, on insulin sensitivity in obese patients with non-insulin-dependent diabetes mellitus (NIDDM) independently of its action on body weight.

RESEARCH DESIGN AND METHODS

In a randomized, double-blind, placebo-controlled trial, insulin-mediated glucose disposal was measured in 12 obese patients with NIDDM on diet alone before and after four weeks of treatment with either placebo (n = 6) or fluoxetine (n = 6) at a dose level of 60 mg once a day. Insulin-mediated glucose disposal was assessed by the 2-step euglycemic hyperinsulinemic clamp technique. Patients were instructed on a weight-maintaining diet.

RESULTS

Insulin infusion at 40 mU.m-2.min-1 resulted in insulin levels of 720 +/- 70 pmol. L-1 with a mean plasma glucose value of 6.4 +/- 0.2 mmol. L-1. Compared to placebo, fluoxetine increased glucose disposal (M) by 2.4-fold (P < 0.05), the insulin sensitivity index (M/I) by 2.7-fold (P < 0.03) and the glucose metabolic clearance rate (MCR) by 2.9-fold (P < 0.03). Insulin infusion at 400 mU.m-2. min-1 elicited insulin levels of 12947 +/- 1512 pmol. L-1 with a mean plasma glucose value of 5.6 +/- 0.4 mmol. L-1. Compared to placebo, fluoxetine increased M by 30% (P = NS), M/I by 40% (P < 0.04) and MCR by 23% (P < 0.04). Patient weight remained stable throughout the study with no change in dietary intake.

CONCLUSION

Fluoxetine improves insulin-mediated glucose disposal in obese patients with NIDDM independently of weight loss.

摘要

目的

研究特异性5-羟色胺再摄取抑制剂氟西汀对非胰岛素依赖型糖尿病（NIDDM）肥胖患者胰岛素敏感性的影响，而不考虑其对体重的作用。

研究设计与方法

在一项随机、双盲、安慰剂对照试验中，对12例仅通过饮食控制的NIDDM肥胖患者进行研究，这些患者被随机分为两组，分别接受安慰剂（n = 6）或氟西汀（n = 6，剂量为每日60 mg）治疗，为期四周。治疗前后采用两步法正常血糖高胰岛素钳夹技术测定胰岛素介导的葡萄糖处置。患者遵循维持体重的饮食方案。

结果

以40 mU·m-2·min-1的速率输注胰岛素时，胰岛素水平达到720±70 pmol·L-1，平均血浆葡萄糖值为6.4±0.2 mmol·L-1。与安慰剂相比，氟西汀使葡萄糖处置（M）增加了2.4倍（P < 0.05），胰岛素敏感性指数（M/I）增加了2.7倍（P < 0.03），葡萄糖代谢清除率（MCR）增加了2.9倍（P < 0.03）。以400 mU·m-2·min-1的速率输注胰岛素时，胰岛素水平达到12947±1512 pmol·L-1，平均血浆葡萄糖值为5.6±0.4 mmol·L-1。与安慰剂相比，氟西汀使M增加了30%（P =无显著性差异），M/I增加了40%（P < 0.04），MCR增加了23%（P < 0.04）。在整个研究过程中患者体重保持稳定，饮食摄入量无变化。