在PROMISE队列中,他类药物治疗与胰岛素敏感性和β细胞功能的纵向关联
Kira Zhi Hua Lai1, Stewart B Harris2, Ravi Retnakaran3,4,5
1Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.
The Journal of clinical endocrinology and metabolism
|January 17, 2025
概括
立方体使用与胰岛素敏感性降低和β细胞功能受损有关,增加2型糖尿病的风险. 影响因他类型和性别而异,突出了个性化的风险评估需求.
科学领域:
- 内分泌学 在内分泌学.
- 代谢研究的研究.
- 预防心血管疾病预防心血管疾病
背景情况:
- 类药物有效地降低了LDL胆固醇和心血管风险.
- 然而,分析表明,在使用他类药物时,新发型2型糖尿病的风险增加.
- 关于他类药物对胰岛素敏感性和β细胞功能影响的数据有限.
研究的目的:
- 研究他类药物治疗对2型糖尿病早期风险表型的纵向影响.
- 评估2型糖尿病风险人群的胰岛素敏感性和β细胞功能变化.
主要方法:
- 利用了来自PROMISE队列的数据,这是一项针对高危成年人的9年纵向研究.
- 在基线和随访时测量胰岛素敏感性 (HOMA2-%S) 和β细胞功能 (ISSI-2).
- 使用通用估计方程来分析自我报告的他类药物使用和代谢标记之间的关联.
主要成果:
- 与非使用者相比,静止剂使用者 (n=169) 的胰岛素敏感性 (5.32-6.36%) 和β细胞功能 (4.93-7.59%) 显著降低.
- 罗斯瓦斯塔丁与胰岛素敏感性降低和β细胞功能相关.
- 阿托瓦斯塔丁与这两种参数都显示出中度的反向关联;影响在性别之间有所不同.
结论:
- 静止剂治疗与胰岛素敏感性降低和β细胞功能相关.
- 在他类药物中和性别之间观察到的差异效应需要进一步研究.
- 研究结果表明,需要在他类药物治疗中进行个性化风险-益处评估.
相关概念视频
Oral Hypoglycemic Agents: Biguanides and Glitazones
165
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
165
Dipeptidyl Peptidase 4 Inhibitors
165
Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
165
Insulin: Dosing Regimen and Adverse Effects
141
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
141
Glucagon-like Receptor Agonists
295
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
295
Oral Hypoglycemic Agents: Glinides
136
Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
136
Insulin: The Receptor and Signaling Pathways
1.1K
Insulin action is mediated through a receptor tyrosine kinase, akin to the IGF-1 receptor. The number of receptors per cell varies significantly, from 40 on erythrocytes to 300,000 on adipocytes and hepatocytes. The insulin receptor consists of linked α/β subunit dimers, forming a heterotetramer glycoprotein with two extracellular α subunits and two β subunits spanning the membrane. The α subunits inhibit the inherent tyrosine kinase activity of the β subunits, but...
1.1K


