The acute effects of HIV protease inhibitors on insulin suppression of glucose production in healthy HIV-negative men.
The acute effects of HIV protease inhibitors on insulin suppression of glucose production in healthy HIV-negative men.
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DOI：
10.1097/qai.0b013e3181b03214
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发表时间：
2009-10-01
期刊：
影响因子：
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通讯作者：
Grunfeld C
中科院分区：
文献类型：
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作者：
Lee GA;Schwarz JM;Patzek S;Kim S;Dyachenko A;Wen M;Mulligan K;Schambelan M;Grunfeld C
不同的HIV蛋白酶抑制剂（PI）对外周胰岛素抵抗的影响已被描述，但对它们对内源性葡萄糖产生（EGP）的胰岛素抑制的影响知之甚少。我们测试了三种PI，茚地那韦，利托那韦和安普那韦，在高胰岛素，正葡萄糖钳夹试验中，在三个类似的安慰剂对照方案中，通过稳定同位素技术定量EGP的急性效应。在高胰岛素血症状态下，茚地那韦的EGP高于安慰剂（4.1±1.3 vs. 2.2±0.8 µg/kg*min，p=0.04）。利托那韦组EGP有升高趋势（3.6±0.3 vs. 3.0±0.5 µg/kg*min，p=0.08）。没有证据表明安普那韦与安慰剂相比减弱EGP的胰岛素抑制（2.9±0.04 vs. 3.2±0.7 µg/kg*min，p=0.63）。一些PI可以急性钝化胰岛素抑制EGP的能力，但是，与胰岛素抵抗一样，PI对EGP的影响是药物特异性的，而不是类别特异性的。
The effects of different HIV protease inhibitors (PIs) on peripheral insulin resistance have been described, but less is known about their effects on insulin suppression of endogenous glucose production (EGP). We tested the acute effects of three PIs, indinavir, ritonavir and amprenavir, on EGP quantified by stable isotope techniques during the hyperinsulinemic, euglycemic clamp in three similar placebo-controlled protocols. EGP was higher with indinavir in the hyperinsulinemic state than with placebo (4.1±1.3 vs. 2.2±0.8 µg/kg*min, p=0.04). A trend towards higher EGP was seen with ritonavir (3.6±0.3 vs. 3.0±0.5 µg/kg*min, p=0.08). There was no evidence that amprenavir blunted insulin suppression of EGP compared to placebo (2.9±0.04 vs. 3.2±0.7 µg/kg*min, p=0.63). Some PIs can acutely blunt the ability of insulin to suppress EGP, but, as with insulin resistance, the effects of PIs on EGP are drug-specific, not class-specific.