Long-term effects of fluoxetine on glycemic control in obese patients with non-insulin-dependent diabetes mellitus or glucose intolerance: influence on muscle glycogen synthase and insulin receptor kinase activity
| Autor: | Ulla Bjerre, Arne Astrup, Søren Jacobsen, Leif Breum, Jens F. Bak |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Time Factors Endocrinology Diabetes and Metabolism medicine.medical_treatment Impaired glucose tolerance Endocrinology Weight loss Diabetes mellitus Internal medicine Fluoxetine Glucose Intolerance medicine Humans Obesity Kinase activity Glycogen synthase Glycemic biology business.industry Insulin Muscles Middle Aged medicine.disease Receptor Insulin Insulin receptor Glycogen Synthase Diabetes Mellitus Type 2 biology.protein Body Composition Female medicine.symptom business Selective Serotonin Reuptake Inhibitors |
| Zdroj: | Metabolism: clinical and experimental. 44(12) |
| ISSN: | 0026-0495 |
| Popis: | Fluoxetine (F) is a specific serotonin-reuptake inhibitor that has been shown to promote weight loss and improve glycemic control in obese diabetic patients. To study its long-term metabolic effect, 40 obese patients with non-insulin -dependent diabetes mellitus (NIDDM) or impaired glucose tolerance (IGT) were included in a 12-month, randomized, placebo controlled study. Patients were assigned to receive either 60 mg F or placebo (P) daily in conjunction with a 5.0-MJ/d diet (> 50% carbohydrate). Both groups showed a significant weight loss, with a nadir after 6 months without group differences (mean +/- SD: F, 10.1 +/- 10.0 kg; P, 9.4 +/- 11.5 kg). Fifteen patients from the F group and 14 from the P group completed the 12-month study without weight loss differences. Glycemic regulation improved along with the weight loss, but with a larger decline in plasma C-peptide and fasting glucose levels on the F group (P < .05). Total skeletal muscle glycogen synthase (GS) activity increased by 31% in the F group (P < .01) and by 17% in the P group (nonsignificant) after 6 months of treatment, but was still less than the activity in normal-weight controls (aged 28.0 +/- 6.3 years; body mass index, 23.5 +/- 2.2). After adjustment for fasting glucose, insulin, weight loss, and diabetic state, a positive effect of F remained on the total GS activity, which accounted for 27% of the variation (P < .05). The waist to hip ratio was reduced in P subjects as compared with F subjects (P < .05). Fat-free mass (FFM) tended to be more reduced in the F group as compared with P subjects (4.9 v 1.9 kg), although the difference did not reach statistical significance. In conclusion, F seems to improve insulin sensitivity beyond the effect mediated through weight loss by a possible effect on GS activity in skeletal muscle tissue. |
| Databáze: | OpenAIRE |
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