We investigated whether long-term glimepiride (GP) monotherapy improves insulin resistance and exerts a beneficial effect on beta cell function, as compared with glibenclamide (GC). One hundred Japanese Type 2 diabeti...We investigated whether long-term glimepiride (GP) monotherapy improves insulin resistance and exerts a beneficial effect on beta cell function, as compared with glibenclamide (GC). One hundred Japanese Type 2 diabetic patients were randomly assigned to the GP (n = 50) or the GC (n = 50) group. During a 5-year monitoring period, patients received the indicated SU monotherapy, while changes in SU doses were allowed as needed to maintain HbA1C below 7.0%. The GC group, in parallel with fasting insulin, showed a rapid homeostatic model assessment (HOMA)-R increase and maintained a high HOMA-R level. In contrast, HOMA-R in the GP group decreased continuously, from 2.9 at baseline to 1.8 at study completion. In the GC group, HOMA-b was markedly increased in the first 6 months, then gradually decreased through 18 months. While the HOMA-β elevation in the GP group was more moderate than that in the GC group, HOMA-β levels were maintained with a slight decrease. The cumulative macrovascular disease outcome was 1 for the GP and 7 for the GC group, showing a significant difference. These results suggest that glimepiride monotherapy markedly improved HOMA-R with moderate insulin stimulation, which may account for the difference in macrovascular disease development as compared with the group receiving glibenclamide.展开更多
Objectives To elucidate the re-lationship of plasma interleukin -6 (IL-6) to themetabolic measures associated with insulin resistance(IR) due to adiposity. Methods For a cross-sectionalstudy, eighty normotensive men w...Objectives To elucidate the re-lationship of plasma interleukin -6 (IL-6) to themetabolic measures associated with insulin resistance(IR) due to adiposity. Methods For a cross-sectionalstudy, eighty normotensive men with and without obe-sity were enrolled consecutively in our health exami-nation center. Fasting blood glucose (FBG), fastingplasma immunoreactive insulin (FIRI), HOMA -R(Homeostasis Model Assessment Insulin ResistanceIndex), plasma lipids (cholesterol, triglyceride, highdensity lipoprotein cholesterol), cortisol, dehy-droepiandrosterone-sulfate (DHEA - S), interleukin -6and C-reactive protein(CRP) were measured. ResultsPlasma levels of FIRI, triglyceride (TG), DHEA-S,CRP and HOMA -R were significantly higher inobese group with BMI over 25 than non-obese group,whereas HDL -C was significantly lower in obesegroup. BMI was positively correlated with FIRI, TG,hsCRP and HOMA-R, whereas negatively with HDL-C. BMI was positively correlated with plasma DHEA-S levels but not with cortisol. Plasma levels of IL-6were positively correlated with FIRI, TG, CRP andHOMA-R but in a multiple regression analysis withIL-6, only HOMA-R and TG remained explainablevariables. Conclusions Each of commonly used mea-sures of inflammatory reaction, CRP and IL-6, showeda significantly positive correlation with either FIRI orHOMA-R, suggesting associations between subclinicalinflammation and obesity as the risk of type 2 dia-betes mellitus.展开更多
文摘We investigated whether long-term glimepiride (GP) monotherapy improves insulin resistance and exerts a beneficial effect on beta cell function, as compared with glibenclamide (GC). One hundred Japanese Type 2 diabetic patients were randomly assigned to the GP (n = 50) or the GC (n = 50) group. During a 5-year monitoring period, patients received the indicated SU monotherapy, while changes in SU doses were allowed as needed to maintain HbA1C below 7.0%. The GC group, in parallel with fasting insulin, showed a rapid homeostatic model assessment (HOMA)-R increase and maintained a high HOMA-R level. In contrast, HOMA-R in the GP group decreased continuously, from 2.9 at baseline to 1.8 at study completion. In the GC group, HOMA-b was markedly increased in the first 6 months, then gradually decreased through 18 months. While the HOMA-β elevation in the GP group was more moderate than that in the GC group, HOMA-β levels were maintained with a slight decrease. The cumulative macrovascular disease outcome was 1 for the GP and 7 for the GC group, showing a significant difference. These results suggest that glimepiride monotherapy markedly improved HOMA-R with moderate insulin stimulation, which may account for the difference in macrovascular disease development as compared with the group receiving glibenclamide.
文摘Objectives To elucidate the re-lationship of plasma interleukin -6 (IL-6) to themetabolic measures associated with insulin resistance(IR) due to adiposity. Methods For a cross-sectionalstudy, eighty normotensive men with and without obe-sity were enrolled consecutively in our health exami-nation center. Fasting blood glucose (FBG), fastingplasma immunoreactive insulin (FIRI), HOMA -R(Homeostasis Model Assessment Insulin ResistanceIndex), plasma lipids (cholesterol, triglyceride, highdensity lipoprotein cholesterol), cortisol, dehy-droepiandrosterone-sulfate (DHEA - S), interleukin -6and C-reactive protein(CRP) were measured. ResultsPlasma levels of FIRI, triglyceride (TG), DHEA-S,CRP and HOMA -R were significantly higher inobese group with BMI over 25 than non-obese group,whereas HDL -C was significantly lower in obesegroup. BMI was positively correlated with FIRI, TG,hsCRP and HOMA-R, whereas negatively with HDL-C. BMI was positively correlated with plasma DHEA-S levels but not with cortisol. Plasma levels of IL-6were positively correlated with FIRI, TG, CRP andHOMA-R but in a multiple regression analysis withIL-6, only HOMA-R and TG remained explainablevariables. Conclusions Each of commonly used mea-sures of inflammatory reaction, CRP and IL-6, showeda significantly positive correlation with either FIRI orHOMA-R, suggesting associations between subclinicalinflammation and obesity as the risk of type 2 dia-betes mellitus.
