PHENYTOIN-INDUCED INSULIN INSENSITIVITY
PHENYTOIN-INDUCED INSULIN INSENSITIVITY
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DOI：
10.1111/j.1464-5491.1991.tb01539.x
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发表时间：
1991-12-01
影响因子：
3.5
通讯作者：
RYAN, EA
中科院分区：
文献类型：
--
作者：
ALRUBEAAN, K;RYAN, EA
苯妥英可引起高血糖。一般认为其机制主要是抑制胰岛素释放。我们最近治疗了一位因苯妥英引起高血糖的患者，其胰岛素需求明显增加，提示胰岛素抵抗状态。减少苯妥英剂量可改善高血糖。苯妥英在脂肪细胞原代培养系统中的体外研究表明，在苯妥英存在的情况下，最大[C-14]3-0-甲基葡萄糖转运减少了57%，而对最大胰岛素结合没有影响。这些结果表明，苯妥英可以通过诱导胰岛素作用的结合后缺陷导致胰岛素不敏感。
Phenytoin is known to induce hyperglycaemia. The mechanism has generally been considered primarily an inhibition of insulin release. We have recently treated a patient who became hyperglycaemic on phenytoin and whose markedly increased insulin requirements suggested an insulin resistant state. Reduction of the phenytoin dose resulted in amelioration of the hyperglycaemia. In vitro studies of phenytoin in a primary culture system of adipocytes that allowed assessment of both insulin receptor binding and post-binding function showed a 57 % reduction in maximum [C-14]3-0-methylglucose transport in the presence of phenytoin while having no effect on maximum insulin binding. These results suggest that phenytoin administration can result in insulin insensitivity by inducing a post-binding defect in insulin action.