Kawamori R, Matsuhisa M, Kinoshita J, Mochizuki K, Niwa M, Arisaka T, Ikeda M, Kubota M, Wada M, Kanda T, Ikebuchi M, Tohdo R, Yamasaki Y
Department of Medicine, Metabolism and Endocrinology, Juntendo University School of Medicine, Tokyo, Japan.
Diabetes Res Clin Pract. 1998 Jul;41(1):35-43. doi: 10.1016/s0168-8227(98)00056-4.
To evaluate the effect of pioglitazone on insulin resistance in non-insulin-dependent diabetes mellitus (NIDDM) patients, a double-blind placebo-controlled trial was carried out with 30 NIDDM patients. Twenty-one subjects, three on diet alone and 18 on sulfonylurea (SU), orally received 30 mg pioglitazone once daily for 12 weeks. Nine subjects, one on diet alone and eight on SU, received a matching placebo once daily for 12 weeks. Euglycemic (5.2 mmol/l) hyperinsulinemic (1200 pmol/l) clamp combined with an oral glucose load (OGL) was performed before and after 3-month treatment with pioglitazone or placebo to determine insulin-stimulated glucose disposal and splanchnic glucose uptake (SGU). No significant differences existed in the patients' characteristics, including age and body mass index, between the two study groups. The pioglitazone treatment increased the mean glucose infusion rate (GIR) prior to OGL from 8.2 +/- 2.2 to 9.2 +/- 2.0 mg/kg.min (mean +/- SD, P = 0.003) and increased the SGU rate from 28.5 +/- 19.4 to 59.4 +/- 27.1% (P = 0.010). The placebo treatment produced no significant changes in either GIR or SGU after treatment. A significant difference (P = 0.042) was observed in change of SGU between the pioglitazone and placebo treatment groups. In conclusion, the results indicate that pioglitazone is effective for ameliorating insulin resistance in NIDDM by enhancing SGU as well as peripheral glucose uptake.
为评估吡格列酮对非胰岛素依赖型糖尿病（NIDDM）患者胰岛素抵抗的影响，对30例NIDDM患者进行了一项双盲安慰剂对照试验。21名受试者，其中3名仅接受饮食治疗，18名接受磺脲类药物（SU）治疗，口服30 mg吡格列酮，每日1次，共12周。9名受试者，其中1名仅接受饮食治疗，8名接受SU治疗，口服匹配的安慰剂，每日1次，共12周。在接受吡格列酮或安慰剂治疗3个月前后，进行了正常血糖（5.2 mmol/l）高胰岛素血症（1200 pmol/l）钳夹试验并结合口服葡萄糖负荷（OGL），以确定胰岛素刺激的葡萄糖处置和内脏葡萄糖摄取（SGU）。两个研究组患者的特征，包括年龄和体重指数，无显著差异。吡格列酮治疗使OGL前的平均葡萄糖输注率（GIR）从8.2±2.2增加到9.2±2.0 mg/kg·min（平均值±标准差，P = 0.003），并使SGU率从28.5±19.4增加到59.4±27.1%（P = 0.010）。安慰剂治疗后GIR和SGU均无显著变化。吡格列酮组和安慰剂组在SGU变化方面观察到显著差异（P = 0.042）。总之，结果表明吡格列酮通过增强SGU以及外周葡萄糖摄取，对改善NIDDM患者的胰岛素抵抗有效。
