Yamakita T, Ishii T, Mori T, Yoshioka K, Sato T, Tanaka S, Kurimasa H, Fujita K, Fujii S
Department of Internal Medicine, Osaka City General Hospital, Osaka, Japan.
Diabetes Res Clin Pract. 1998 Dec;42(3):205-8. doi: 10.1016/s0168-8227(98)00111-9.
We report a patient with Prader-Willi syndrome (PWS) complicated by diabetes mellitus. PWS is a genetic disorder characterized by obesity, mental retardation and hypogonadism. Glucose intolerance in this syndrome is thought to be secondary to insulin resistance associated with morbid obesity. Therapy was directed primarily at decreasing insulin resistance and thereby improving glucose intolerance by the administration of troglitazone, which increases insulin sensitivity. Changes in glucose disposal rate assessed by euglycemic hyperinsulinemic clamp test were measured, as well as glucose and insulin responses to a 75 g-OGTT before and after troglitazone therapy. Glucose disposal rate increased by 36% and plasma glucose responses to 75 g-OGTT decreased by about 50% during 12 weeks of troglitazone therapy despite slight weight gain. Thus, troglitazone has beneficial effects on glycemic control by improving insulin sensitivity in patients with PWS complicated by diabetes mellitus.
我们报告了一名患有普拉德-威利综合征（PWS）并伴有糖尿病的患者。PWS是一种遗传性疾病，其特征为肥胖、智力发育迟缓及性腺功能减退。该综合征中的葡萄糖不耐受被认为是继发于与病态肥胖相关的胰岛素抵抗。治疗主要针对降低胰岛素抵抗，从而通过给予曲格列酮来改善葡萄糖不耐受，曲格列酮可增加胰岛素敏感性。我们测量了通过正常血糖高胰岛素钳夹试验评估的葡萄糖处置率变化，以及曲格列酮治疗前后对75克口服葡萄糖耐量试验（OGTT）的葡萄糖和胰岛素反应。尽管体重略有增加，但在曲格列酮治疗的12周期间，葡萄糖处置率提高了36%，对75克OGTT的血浆葡萄糖反应降低了约50%。因此，曲格列酮通过改善患有PWS并伴有糖尿病的患者的胰岛素敏感性，对血糖控制具有有益作用。
