THE INFLUENCE OF INSULIN-ANTIBODIES ON THE PHARMACOKINETICS OF NPH INSULIN IN PATIENTS WITH TYPE-1 DIABETES TREATED WITH HUMAN INSULIN

被引：20

作者：

PETERS, A

KLOSE, O

HEFTY, R

KECK, F

KERNER, W

机构：

[1] Department of Internal Medicine, Medical University of Lübeck

[2] Department of Internal Medicine, University of Ulm

来源：

DIABETIC MEDICINE | 1995年 / 12卷 / 10期

关键词：

ANTIBODY-BOUND INSULIN; FREE INSULIN; HUMAN NPH INSULIN; EUGLYCEMIC CLAMP;

D O I：

10.1111/j.1464-5491.1995.tb00398.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The influence of insulin binding antibodies on the pharmacokinetics of NPH insulin was studied in Type 1 diabetic patients on human insulin. Insulin-antibody binding (B-0) was measured during a screening procedure in 155 Type 1 diabetic patients. In 36 patients, B-0 was <1.5 %, and in 38 patients B-0 was >10.0 %. Of these, 6 patients, group 1 (B-0 < 1.5 %) and 8 patients, group 2 (B-0 > 10.0 %), respectively, subsequently participated in a pharmacokinetic study. Free insulin and the glucose infusion rate were measured using a euglycaemic clamp after subcutaneous injection of NPH insulin (0.4 U kg(-1)). The areas under the curve (AUG) of free insulin concentration were smaller for group 2 (p = 0.01) than for group 1 (212.2 +/- 22.0 vs 316.8 +/- 25.3 mU l(-1) h). The AUCs of the glucose infusion rate were also smaller for group 2 (p < 0.05) than for group 1 (2.50 +/- 0.32 vs 3.58 +/- 0.36 g kg(-1)). A significant negative correlation exists between the AUCs for free insulin concentration and insulin-antibody binding B-0 (r = 0.76, p = 0.001). The daily insulin dosage was higher in group 2 (p = 0.02) than in group 1 (0.66 +/- 0.03 vs 0.53 +/- 0.03 U kg(-1)). We conclude that insulin antibodies influence the pharmacokinetics of NPH human insulin. The demonstrable influence on the kinetics of free insulin and glucose utilization leads to a slight increase in daily total insulin requirements.

引用

页码：925 / 931

页数：7

共 30 条

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