Effect of pioglitazone on pancreatic β-cell function and diabetes risk in Hispanic women with prior gestational diabetes
Effect of pioglitazone on pancreatic β-cell function and diabetes risk in Hispanic women with prior gestational diabetes
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DOI：
10.2337/diabetes.55.02.06.db05-1066
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发表时间：
2006-02-01
期刊：
影响因子：
7.7
通讯作者：
Buchanan, TA
中科院分区：
文献类型：
--
作者：
Xiang, AH;Peters, RK;Buchanan, TA
吡格列酮预防糖尿病 (PIPOD) 研究旨在评估已完成曲格列酮预防糖尿病 (TRIPOD) 研究的既往妊娠期糖尿病的西班牙裔女性在接受吡格列酮治疗期间的 β 细胞功能、胰岛素抵抗和糖尿病发病率。完成 TRIPOD 研究的女性将被邀请参加 PIPOD 研究，接受计划的 3 年药物治疗和 6 个月的药物清除后治疗。每年对吡格列酮进行口服葡萄糖耐量试验，并在药物清除结束时进行。在基线、使用吡格列酮 1 年后以及药物清除结束时进行静脉葡萄糖耐量试验 (IVGTT)，以评估胰岛素敏感性和 β 细胞功能。在 TRIPOD 研究结束时未患有糖尿病的 95 名女性中，有 89 人参加了 PIPOD 研究，86 人完成了至少一次随访，65 人完成了所有研究访视，包括药物后测试。 TRIPOD 和 PIPOD 研究中胰岛素抵抗的 β 细胞补偿变化的比较显示，吡格列酮阻止了 TRIPOD 研究中安慰剂治疗期间发生的 β 细胞功能下降，并维持了 TRIPOD 研究中曲格列酮治疗期间发生的 β 细胞功能的稳定性。治疗 1 年后 IVGTT 胰岛素总面积减少最多的女性患糖尿病的风险最低，平均每年发生率为 4.6%。 PIPOD 和 TRIPOD 研究结果的相似性支持噻唑烷二酮类药物具有增强胰岛素敏感性、减少胰岛素分泌需求和保护胰腺 β 细胞功能的类效应，所有这些都与既往妊娠期糖尿病的西班牙裔女性相对较低的 2 型糖尿病发病率相关。
The Pioglitazone In Prevention Of Diabetes (PIPOD) study was conducted to evaluate beta-cell function, insulin resistance, and the incidence of diabetes during treatment with pioglitazone in Hispanic women with prior gestational diabetes who had completed participation in the Troglitazone In Prevention Of Diabetes (TRIPOD) study. Women who completed the TRIPOD study were offered participation in the PIPOD study for a planned 3 years of drug treatment and 6 months of postdrug washout. Oral glucose tolerance tests were performed annually on pioglitazone and at the end of the postdrug washout. Intravenous glucose tolerance tests (IVGTTs) for assessment of insulin sensitivity and beta-cell function were conducted at baseline, after 1 year on pioglitazone, and at the end of the postdrug washout. Of 95 women who were not diabetic at the end of the TRIPOD study, 89 enrolled in the PIPOD study, 86 completed at least one follow-up visit, and 65 completed all study visits, including the postdrug tests. Comparison of changes in beta-cell compensation for insulin resistance across the TRIPOD and PIPOD studies revealed that pioglitazone stopped the decline in beta-cell function that occurred during placebo treatment in the TRIPOD study and maintained the stability of beta-cell function that had occurred during troglitazone treatment in the TRIPOD study. The risk of diabetes, which occurred at an average rate of 4.6% per year, was lowest in women with the largest reduction in total IVGTT insulin area after 1 year of treatment. The similarity of findings between the PIPOD and TRIPOD studies support a class effect of thiazolidinedione drugs to enhance insulin sensitivity, reduce insulin secretory demands, and preserve pancreatic beta-cell function, all in association with a relatively low rate of type 2 diabetes, in Hispanic women with prior gestational diabetes.