RT Journal Article
SR Electronic
T1 Troglitazone Improves Whole-Body Insulin Resistance and Skeletal Muscle Glucose Use in Type II Diabetic Patients
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1005
OP 1010
VO 42
IS 7
A1 Ikuo Yokoyama
A1 Katsunori Yonekura
A1 Toshiyuki Moritan
A1 Madoka Tateno
A1 Toshimitsu Momose
A1 Kuni Ohtomo
A1 Yusuke Inoue
A1 Ryozo Nagai
YR 2001
UL http://jnm.snmjournals.org/content/42/7/1005.abstract
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.