噻唑烷二酮类不良反应研究进展

Advancement in the adverse effects of thiazolidinediones

噻唑烷二酮类胰岛素增敏剂通过增加外周组织对胰岛素的敏感性而改善胰岛素抵抗,降低血胰岛素水平、减少胰岛素用量,降低血糖和HbA1c,提高HDL-C水平,保护胰岛β细胞功能;还能对抗多种心血管疾病危险因子的损害,有益于糖尿病大血管和微血管并发症的防治。然而近年来有关噻唑烷二酮类药物不良反应的报道越来越多,部分病人甚至因此而停药。笔者综述噻唑烷二酮类药物不良反应。

Thiazolidinediones （TZDs） improve the way cells an the body respond to insulin by lowering insulin resistance. These drugs increase peripheral glucose utilization in skeletal muscle and adipose tissue, reduce hepatic glucose output, increase fatty acid uptake and reduce lipolysis in adipose cells. This ultimately preserves islet beta-cell function, leading to a reduction of fasting and post-prandial plasma glucose, insulin and circulating free fatty acid （FFA） levels, and slightly less potent at reducing the level of HbAlc TZDs are considered a new class of drugs for the treatment of type 2 diabetes mellitus and other diseases associated with insulin resistance syndrome. Safety concerns on the TZDs, however, have been a primary focus of pharmacotherapeutics. One of the TZDs was withdrawn from the marketing due to severe hepatotoxicity. This paper summarized the safety profile of TZDs.