Effects of troglitazone on atherogenic lipoprotein phenotype in coronary patients with insulin resistance

被引:33
作者
Sunayama, S [1 ]
Watanabe, Y [1 ]
Ohmura, H [1 ]
Sawano, M [1 ]
Shimada, K [1 ]
Mokuno, H [1 ]
Daida, H [1 ]
Yamaguchi, H [1 ]
机构
[1] Juntendo Univ, Dept Cardiol, Bunkyo Ku, Tokyo 1138421, Japan
关键词
insulin resistance syndrome; lipoprotein lipase; LDL size; triglycerides; coronary artery disease;
D O I
10.1016/S0021-9150(99)00138-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Insulin resistance is associated with atherogenic lipoprotein phenotype, including small dense LDL particle, hypertriglycemia and low HDL cholesterol levels. Troglitazone, a novel insulin sensitizing agent, may improve the associated lipid profile in patients with insulin resistance. We examined the effects of troglitazone (400 mg daily for 12 weeks) in 12 non-diabetic coronary patients (60 +/- 10 years), all of whom had hyperinsulinemic response to an oral glucose load. Troglitazone markedly reduced the insulin response. After the treatment, plasma triglycerides decreased by 32% (P < 0.05), HDL cholesterol increased by 11% (P < 0.05) and LDL peak particle diameter increased from 24.7 +/- 0.3 to 25.5 +/- 0.5 nm (P < 0.01). These lipidic improvements were associated with a significant rise in postheparin lipoprotein lipase levels (175 +/- 52 to 217 +/- 69 ng/ml, P < 0.01). In patients with insulin resistance syndrome, troglitazone improved the atherogenic lipoprotein phenotype as well as hyperinsulinemia. Our data suggest that troglitazone therapy could reduce the atherosclerotic risk due to insulin resistance even in non-diabetic patients. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.
引用
收藏
页码:187 / 193
页数:7
相关论文
共 33 条
  • [11] HOMMA Y, 1985, ARTERY, V13, P19
  • [12] IKEDA Y, 1990, J LIPID RES, V31, P1911
  • [13] KNUDSEN P, 1995, DIABETOLOGIA, V38, P344
  • [14] KRAUSS RM, 1982, J LIPID RES, V23, P97
  • [15] KRAUSS RM, 1973, J LIPID RES, V14, P286
  • [16] Kumar S, 1996, DIABETOLOGIA, V39, P701
  • [17] Regulation of lipoprotein metabolism by thiazolidinediones occurs through a distinct but complementary mechanism relative to fibrates
    Lefebvre, AM
    PeinadoOnsurbe, J
    Leitersdorf, I
    Briggs, MR
    Paterniti, JR
    Fruchart, JC
    Fievet, C
    Auwerx, J
    Staels, B
    [J]. ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 1997, 17 (09) : 1756 - 1764
  • [18] Acute effects of insulin in the control of VLDL production in humans - Implications for the insulin-resistant state
    Lewis, GF
    Steiner, G
    [J]. DIABETES CARE, 1996, 19 (04) : 390 - 393
  • [19] PPARγ activators improve glucose homeostasis by stimulating fatty acid uptake in the adipocytes
    Martin, G
    Schoonjans, K
    Staels, B
    Auwerx, J
    [J]. ATHEROSCLEROSIS, 1998, 137 : S75 - S80
  • [20] HOMEOSTASIS MODEL ASSESSMENT - INSULIN RESISTANCE AND BETA-CELL FUNCTION FROM FASTING PLASMA-GLUCOSE AND INSULIN CONCENTRATIONS IN MAN
    MATTHEWS, DR
    HOSKER, JP
    RUDENSKI, AS
    NAYLOR, BA
    TREACHER, DF
    TURNER, RC
    [J]. DIABETOLOGIA, 1985, 28 (07) : 412 - 419