Abstract:
OBJECTIVE:Anti-inflammatory glucocorticoid (GC) therapy often induces hyperglycemia due to insulin resistance and islet-cell dysfunction. Incretin-based therapies may preserve glucose tolerance and pancreatic islet-cell function. In this study, we hypothesized that concomitant administration of the dipeptidyl peptidase-4 inhibitor sitagliptin and prednisolone in men at high risk to develop type 2 diabetes could protect against the GC-induced diabetogenic effects. DESIGN AND METHODS:Men with the metabolic syndrome but without diabetes received prednisolone 30 mg once daily plus sitagliptin 100 mg once daily (n=14), prednisolone (n=12) or sitagliptin alone (n=14) or placebo (n=12) for 14 days in a double-blind 2 × 2 randomized-controlled study. Glucose, insulin, C-peptide, and glucagon were measured in the fasted state and following a standardized mixed-meal test. β-cell function parameters were assessed both from a hyperglycemic-arginine clamp procedure and from the meal test. Insulin sensitivity (M-value) was measured by euglycemic clamp. RESULTS:Prednisolone increased postprandial area under the curve (AUC)-glucose by 17% (P<0.001 vs placebo) and postprandial AUC-glucagon by 50% (P<0.001). Prednisolone reduced 1st and 2nd phase glucose-stimulated- and combined hyperglycemia-arginine-stimulated C-peptide secretion (all P ≤ 0.001). When sitagliptin was added, both clamp-measured β-cell function (P=NS for 1st and 2nd phase vs placebo) and postprandial hyperglucagonemia (P=NS vs placebo) remained unaffected. However, administration of sitagliptin could not prevent prednisolone-induced increment in postprandial glucose concentrations (P<0.001 vs placebo). M-value was not altered by any treatment. CONCLUSION:Fourteen-day treatment with high-dose prednisolone impaired postprandial glucose metabolism in subjects with the metabolic syndrome. Concomitant treatment with sitagliptin improved various aspects of pancreatic islet-cell function, but did not prevent deterioration of glucose tolerance by GC treatment.
journal_name
Eur J Endocrinoljournal_title
European journal of endocrinologyauthors
van Genugten RE,van Raalte DH,Muskiet MH,Heymans MW,Pouwels PJ,Ouwens DM,Mari A,Diamant Mdoi
10.1530/EJE-13-0610subject
Has Abstractpub_date
2014-02-04 00:00:00pages
429-39issue
3eissn
0804-4643issn
1479-683Xpii
EJE-13-0610journal_volume
170pub_type
杂志文章,随机对照试验abstract:OBJECTIVE:Various adjuvant therapies have been introduced along with intensive insulin therapy in patients with recent onset type 1 diabetes. Nicotinamide (NA), administered at diagnosis of the disease, can have beneficial effects on the clinical remission rate, improve metabolic control and preserve or slightly increa...
journal_title:European journal of endocrinology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1530/eje.0.1500719
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abstract:OBJECTIVE:ATL1103 is a second-generation antisense oligomer targeting the human growth hormone (GH) receptor. This phase 2 randomised, open-label, parallel-group study assessed the potential of ATL1103 as a treatment for acromegaly. DESIGN:Twenty-six patients with active acromegaly (IGF-I >130% upper limit of normal) ...
journal_title:European journal of endocrinology
pub_type: 杂志文章,随机对照试验
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更新日期:2018-08-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,评审
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abstract:OBJECTIVE:Affective alterations and poorer quality of life often persist in patients with Cushing's syndrome (CS) in remission. Brain-derived neurotrophic factor (BDNF) regulates the hypothalamic-pituitary-adrenal axis (HPA) and is highly expressed in brain areas controlling mood and response to stress. Our aims were t...
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journal_title:European journal of endocrinology
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pub_type: 杂志文章
doi:10.1530/eje.0.1310582
更新日期:1994-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:1998-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2010-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:1997-07-01 00:00:00
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更新日期:2003-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:2017-04-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
doi:10.1530/EJE-15-0185
更新日期:2015-07-01 00:00:00
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pub_type: 杂志文章
doi:10.1530/EJE-06-0699
更新日期:2007-04-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
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更新日期:2019-11-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
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更新日期:2020-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:1997-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:2014-06-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 杂志文章
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更新日期:2011-06-01 00:00:00
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journal_title:European journal of endocrinology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1997-08-01 00:00:00