α-硫辛酸对肥胖糖耐量减低人群胰岛素敏感性的影响

目的观察抗氧化剂α-硫辛酸（ALA）对肥胖糖耐量减低（IGT）者胰岛素敏感性的影响。方法选择20例肥胖的IGT患者作为研究对象,予ALA 600 mg·d^-1治疗14 d,用高胰岛素-正葡萄糖钳夹方法观察ALA治疗前后胰岛素敏感性的变化,检测治疗前后肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、丙二醛（MDA）及谷胱甘肽（GSH）水平。结果输注ALA后,钳夹过程中稳态下葡萄糖输注率（GIR）升高76%（P<0.001）;TNF-α、IL-6分别下降38%和55%（P<0.05）;MDA水平降低43%,GSH水平升高26%（P<0.05）。结论抗氧化剂ALA能显著改善肥胖IGT人群的胰岛素抵抗,作用机制可能为减轻机体氧化应激,同时下调炎症反应。

Impact of alpha-lipoic acid on insulin sensitivity in individuals with obesity and impaired glucose tolerance

A/M To investigate the impact of intravenously infused antioxidant alpha-lipoic acid（ALA）on insulin sensitivity in individuals with obesity and impaired glucose tolerance（IGT）. METHODS Twenty subjects with IGT were infused AIA 600 mg·d^-1 for 14 d. Insulin sensitivity was measured with glucose infusion rate （GIR） and determined by using hyperinsulinemic-euglucemic clamp method before and after treatment. The interleukin-6（IL-6）, tumor necrosis factor（TNF-α） ,malondialdehyde（MDA） and glutathione（GSH） were examined before and after treatment. RESULTS Compared with pre-therapy ,during hyperinsulinemic-euglycemic clamp, there was a 76% increment in GIR; levels of IL-6, TNF-a decreased 38% and 55% respectively （ P 〈 0.05） ; levels of MDA decreased 43%, and GSH elevated 26% （ P 〈 0.05） after ALA treatment. CONCLUSION The results suggest that intravenous administration of ALA can improve insulin resistance in subjects with obesity and IGT. The possible mechanism of ALA may abate the levels of oxidative stress and down-regulate inflanunatory reactions systemically.