Boosting dose ritonavir does not alter peripheral insulin sensitivity in healthy HIV-seronegative volunteers.
Boosting dose ritonavir does not alter peripheral insulin sensitivity in healthy HIV-seronegative volunteers.
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DOI：
10.1097/qai.0b013e3181e6a7d9
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发表时间：
2010-11
期刊：
影响因子：
--
通讯作者：
Grunfeld C
中科院分区：
文献类型：
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作者：
Taylor SA;Lee GA;Pao VY;Anthonypillai J;Aweeka FT;Schwarz JM;Mulligan K;Schambelan M;Grunfeld C
一些 HIV 蛋白酶抑制剂 (PI)，包括全剂量利托那韦 (800 mg) 和利托那韦增强型洛匹那韦，在没有 HIV 感染和身体成分变化的情况下会急性诱导胰岛素抵抗。增加剂量的利托那韦（100 至 200 mg）是最常用的 PI，但在没有其他 PI 的情况下，尚未描述其对葡萄糖代谢的影响。在这项随机、双盲、交叉研究中，在通过正常血糖高胰岛素钳夹评估胰岛素敏感性之前，给健康的 HIV 血清阴性志愿者服用单剂量的利托那韦 200 mg 或安慰剂。加强剂量的利托那韦对胰岛素介导的葡萄糖处理没有影响（M/I，安慰剂：8.59±0.83 vs. 利托那韦：8.51±0.64 mg/kg/min/μU/mL 胰岛素，p=0.89）。单次加强剂量的利托那韦不会改变胰岛素敏感性，这表明洛匹那韦可能是洛匹那韦/利托那韦先前短期研究中所证实的诱导胰岛素抵抗的原因。利托那韦对胰岛素敏感性存在剂量依赖性影响。
Some HIV protease inhibitors (PI), including full dose ritonavir (800 mg) and ritonavir-boosted lopinavir, acutely induce insulin resistance in the absence of HIV infection and changes in body composition. Boosting-dose ritonavir (100 to 200 mg) is the most commonly prescribed PI, yet its effects on glucose metabolism have not been described in the absence of another PI. In this randomized, double-blind, cross-over study, a single dose of ritonavir 200 mg or placebo was given to healthy HIV-seronegative volunteers before assessment of insulin sensitivity by euglycemic hyperinsulinemic clamp. Boosting dose ritonavir had no effect on insulin-mediated glucose disposal (M/I, placebo: 8.59±0.83 vs. ritonavir: 8.51±0.64 mg/kg per min per μU/mL insulin, p=0.89). A single boosting dose of ritonavir does not alter insulin sensitivity, suggesting lopinavir is likely responsible for the induction of insulin resistance demonstrated in prior short-term studies of lopinavir/ritonavir. There is a dose-dependent effect of ritonavir on insulin sensitivity.