Role of metabolically active hormones in the insulin resistance associated with short-term glucocorticoid treatment.
Role of metabolically active hormones in the insulin resistance associated with short-term glucocorticoid treatment.
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DOI：
10.1186/1477-5751-5-14
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发表时间：
2006-09-11
期刊：
影响因子：
--
通讯作者：
Brotman DJ
中科院分区：
文献类型：
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作者：
Patel JV;Cummings DE;Girod JP;Mascarenhas AV;Hughes EA;Gupta M;Lip GY;Reddy S;Brotman DJ
糖皮质激素治疗促进肥胖和胰岛素抵抗的机制尚不完全清楚。调节代谢活性激素，肿瘤坏死因子α（TNF α），生长激素释放肽，瘦素和脂联素都涉及这些心血管危险因素的发展。关于短期糖皮质激素治疗对这些激素水平的影响知之甚少。使用盲法、安慰剂对照方法，我们将25名健康男性（平均（SD）年龄：24.2（5.4）岁）随机分配至安慰剂或口服地塞米松3 mg每日两次治疗5天。治疗前后测定空腹血浆TNFα、ghrelin、leptin和adiponectin水平。所有激素的平均变化在治疗组之间没有差异，尽管地塞米松相关的体重、血压、HDL胆固醇和胰岛素增加。计算的胰岛素敏感性指数（HOMA-S，胰岛素敏感性指数）的变化与地塞米松治疗密切相关（p < 0.001）。我们的数据不支持TNF α、ghrelin、瘦素或脂联素在短期糖皮质激素治疗相关的胰岛素抵抗中的作用。
The mechanisms by which glucocorticoid therapy promotes obesity and insulin resistance are incompletely characterized. Modulations of the metabolically active hormones, tumour necrosis factor alpha (TNF alpha), ghrelin, leptin and adiponectin are all implicated in the development of these cardiovascular risk factors. Little is known about the effects of short-term glucocorticoid treatment on levels of these hormones. Using a blinded, placebo-controlled approach, we randomised 25 healthy men (mean (SD) age: 24.2 (5.4) years) to 5 days of treatment with either placebo or oral dexamethasone 3 mg twice daily. Fasting plasma TNFα, ghrelin, leptin and adiponectin were measured before and after treatment. Mean changes in all hormones were no different between treatment arms, despite dexamethasone-related increases in body weight, blood pressure, HDL cholesterol and insulin. Changes in calculated indices of insulin sensitivity (HOMA-S, insulin sensitivity index) were strongly related to dexamethasone treatment (p < 0.001). Our data do not support a role for TNF alpha, ghrelin, leptin or adiponectin in the insulin resistance associated with short-term glucocorticoid treatment.