Paradoxically decreased HDL-cholesterol levels associated with rosiglitazone therapy
Paradoxically decreased HDL-cholesterol levels associated with rosiglitazone therapy
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DOI：
10.1345/aph.1h020
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发表时间：
2006-09-01
影响因子：
2.9
通讯作者：
Ooi, Teik Chye
中科院分区：
文献类型：
--
作者：
Gutschi, L. Maria;Malcolm, Janine C.;Ooi, Teik Chye
目的：报告2例非常低的高密度脂蛋白胆固醇（HDL-C）水平与罗格列酮therapy.CASE摘要：2例2型糖尿病患者服用罗格列酮血糖控制开发矛盾低HDL-C水平在罗格列酮治疗。在第一名患者中，HDL-C水平在治疗8个月后从33 mg/dL降至11.6 mg/dL。第二名患者的HDL-C水平在使用罗格列酮4个月后从基线水平44.8 mg/dL降至19.7 mg/dL。这些异常在停用罗格列酮后消退，在患者接受吡格列酮治疗时未观察到。这些患者没有改变其他药物治疗或医疗条件，已知会影响血脂代谢的治疗过程中与罗格列酮。讨论：噻唑烷二酮类，胰岛素增敏剂广泛用于治疗2型糖尿病，已被报道有有益的影响血脂，如甘油三酯降低和HDL-C升高，除了他们的降糖作用。研究表明，罗格列酮和吡格列酮（2种目前可用的噻唑烷二酮类药物）对脂质的影响可能不同。截至2006年7月，共报告了8例罗格列酮相关的血浆HDL-C反常降低病例。基于Naranjo概率量表的使用，此处列出的2例病例很可能与罗格列酮相关。治疗的持续时间可能是重要的，在这种矛盾的effects.CONCLUSIONS：罗格列酮与2型糖尿病患者HDL-C水平的矛盾下降。在接受罗格列酮治疗的患者中，应进行基线血脂检查，并在治疗过程中监测血脂值。
OBJECTIVE: To report 2 cases of very low high-density lipoprotein cholesterol (HDL-C) levels associated with rosiglitazone therapy.CASE SUMMARY: Two patients with type 2 diabetes taking rosiglitazone for glycemic control developed paradoxically low HDL-C levels during rosiglitazone therapy. In the first patient, the HDL-C level decreased from 33 to 11.6 mg/dL after 8 months of therapy. The second patient's HDL-C level decreased from the baseline level of 44.8 mg/dL to 19.7 mg/dL after 4 months of rosiglitazone use. These abnormalities resolved on discontinuation of rosiglitazone and were not observed when the patients were treated with pioglitazone. The patients had no changes to other drug therapy or medical conditions known to affect lipid metabolism during treatment with rosiglitazone.DISCUSSION: Thiazolidinediones, insulin sensitizers widely used in the treatment of type 2 diabetes, have been reported to have beneficial effects on lipids, such as triglyceride lowering and HDL-C elevation, in addition to their glucose-lowering effects. It has been suggested that rosiglitazone and pioglitazone, the 2 currently available thiazolidinediones, may differ in their effects on lipids. As of July 2006, a total of 8 cases of paradoxical lowering of plasma HDL-C associated with rosiglitazone have now been reported. Based on use of the Naranjo probability scale, the 2 cases presented here were probably associated with rosiglitazone. The duration of therapy may be important in this paradoxical effect.CONCLUSIONS: Rosiglitazone is associated with a paradoxical decrease in HDL-C levels in patients with type 2 diabetes. In patients receiving rosiglitazone, a baseline lipid panel should be performed and lipid values should be monitored during the course of therapy.