Pioglitazone Improved Insulin Sensitivity and First Phase Insulin Secretion Among Obese and Lean People with Diabetes: A Multicenter Clamp Study

作者：Qian, Xin; Wang, Hui; Yang, Gangyi; Gao, Zhengnan; Luo, Yong; Dong, Aimei; Zhang, Fang; Xu, Mingtong; Liu, Shiping; Yang, Xin; Chen, Yanyan; Li, Guangwei^*

来源：Diabetes Therapy, 2018, 9(2): 815-826.

DOI：10.1007/s13300-018-0401-9

• First phase
• Insulin resistance
• Insulin secretion
• Pioglitazone

Introduction: To investigate the effects of pioglitazone (PIO) on insulin resistance and first phase insulin secretion among obese and lean Chinese people with type 2 diabetes mellitus (T2DM). @@@ Methods: Sixty-eight drug-naive patients with T2DM were treated with PIO for 16 weeks. Before and after the treatment, insulin sensitivity was evaluated by the euglycemic hyper-insulinemic clamp test. Plasma insulin levels at 0, 3, 5, 7, and 10 min during intravenous glucose tolerance test were determined to calculate the first phase insulin secretion and pancreatic beta-cell function. Circulating adiponectin levels were quantified. @@@ Results: In both the lean and the obese patients with T2DM, the reduction of HbA(1c) following the PIO treatment was more than 1% (P < 0.001) and glucose infusion rate, acute insulin response, glucose disposal index, and beta-cell glucose sensitivity increased significantly (P < 0.001). A multiple linear regression analysis showed that the improvements of first phase insulin secretion and insulin sensitivity were independently associated with the changes of HbA(1c), but the change of first phase insulin secretion exhibited a higher correlation coefficient (R-2 = 0.20, P = 0.001) than the change of insulin sensitivity did (R-2 = 0.07, P = 0.040). The PIO treatment led to a significant increase in adiponectin levels only in the obese group (P < 0.05). @@@ Conclusion: A 16-week treatment of PIO significantly increased insulin sensitivity and beta-cell function in the lean group as well as in the obese group among Chinese T2DM patients, demonstrating that both lean and obese diabetic adults would profit from PIO.

• 出版日期2018-4
• 单位北京大学; 大连市中心医院; 中国医学科学院阜外医院; 北京协和医学院; 中南大学; 中山大学; 重庆医科大学