PT - JOURNAL ARTICLE AU - Ikuo Yokoyama AU - Katsunori Yonekura AU - Toshiyuki Moritan AU - Madoka Tateno AU - Toshimitsu Momose AU - Kuni Ohtomo AU - Yusuke Inoue AU - Ryozo Nagai TI - Troglitazone Improves Whole-Body Insulin Resistance and Skeletal Muscle Glucose Use in Type II Diabetic Patients DP - 2001 Jul 01 TA - Journal of Nuclear Medicine PG - 1005--1010 VI - 42 IP - 7 4099 - http://jnm.snmjournals.org/content/42/7/1005.short 4100 - http://jnm.snmjournals.org/content/42/7/1005.full SO - J Nucl Med2001 Jul 01; 42 AB - Recently, troglitazone has emerged as an insulin sensitizer for the treatment of type II diabetes. However, its effect on skeletal muscle glucose use (SMGU) has not been studied. Methods: To investigate the effect of troglitazone on SMGU in patients with type II diabetes, we undertook skeletal muscle 18F-FDG PET dynamic imaging under insulin clamping before and after administration of SMGU to 20 patients with type II diabetes. Data were compared with those for 12 age-matched healthy volunteers. Results: The whole-body glucose disposal rate (GDR) was significantly lower in patients (29.9 ± 9.83 μmol/min/kg) than in control subjects (55.6 ± 16.5 μmol/min/kg, P < 0.01), as was the SMGU (patients, 3.27 ± 2.17 μmol/min/kg; control subjects, 10.9 ± 6.4μmol/min/kg; P < 0.01). After the therapy, GDR significantly improved in patients (29.3 ± 14.6 μmol/min/kg, P < 0.05), as did SMGU (5.06 ± 2.11 μmol/min/kg, P < 0.05). When results for patients with and without hypertension were separately analyzed, a significant improvement in SMGU after troglitazone was seen in both normotensive and hypertensive patients (normotensive [n = 10]: baseline, 3.67 ± 2.89 μmol/min/kg; after therapy, 5.28 ± 2.61 μmol/min/kg; P < 0.05; hypertensive [n = 10]: baseline, 2.89 ± 1.22 μmol/min/kg; after therapy, 4.72 ± 1.39 μmol/min/kg; P < 0.05). GDR in patients with and without hypertension was significantly improved by troglitazone (normotensive: baseline, 17.9 ± 10.2 μmol/min/kg; after therapy, 31.9 ± 15.9 μmol/min/kg; P < 0.01; hypertensive: baseline, 39.6 ± 15.1 μmol/min/kg; after therapy, 47.7 ± 23.8 μmol/min/kg; P < 0.05). The plasma free fatty acid concentration during insulin clamping was not changed by troglitazone (baseline, 1.1 ± 0.86 mEq/L; after therapy, 0.93 ± 0.65 mEq/L; P = not significant). Conclusion: Troglitazone can improve whole-body insulin resistance through the improvement of SMGU but not through a decline in plasma free fatty acid concentration in patients with type II diabetes with or without hypertension.