2008, Number 2
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ABSTRACTObjective. To determine changes on the index of resistance to insulin of obese patients after treatment with pentoxifylline.
Material and Methods. Adult obese patients of both genders from the Internal Medicine consultation of the HGR # 1, Culiacán, Sinaloa during the period February to May of 1998 were included in the study. The index of resistance to insulin was obtained by (HOMA-IR). Treatment groups were randomly assigned and double blind to group 1 (pentoxifylline, n=11) as follows: 400 mg oral intake every 24 hrs to patients with IMC higher than 25 kg/m2 but lower than 29.9 kg/m2; 400 mg oral intake every 12 hrs to patients with IMC between 30 and 34.9 kg/m2; and 400 mg oral intake every 8 hrs to patients with IMC higher than 35 kg/m2 during two months; and group 2 (placebo, n=11). Glucose and insuline measurements were taken before and after treatment. The STATA.v6 program was used.
Results. Of the 22 patients, 16 were female and 6 were male with a range of age 28 to 54 years old, an average age of 43.3 years. The basal HOMAIR was 4.72 (IC 95% 3.3-6.1) and 4.05 (IC 95% 2.8-5.2) for group 1 and group 2, respectively (p=0.39). After treatment the HOMA-IR was 7.6 (IC 95% 5.5-9.7) and 3.36 (IC 95% 2.0-4.6) for group 1 and group 2, respectively (p=0.001).
Conclusions. Pentoxifylline increased the index of resistance to insulin in obese patients.
Rossner M. Muller R. On the assessment of the efficacy of pentoxifylline (Trental). J Med 1987; 18:1-15.
Stosić-Grujicić S, Maksimović D, Badovinac V, Samardzić T, Trajković V, Lukić M, et al. Antidiabetogenic effect of pentoxifylline is associated with systemic and target tissue modulation of cytokines and nitric oxide production. J Autoimmun 2001; 16:47-58.
Cigolinia M, Agostino G, Borgato L. Plasminogen activator inhibitor-1 in human fat: Effect of tumor necrosis factor-and pentoxifylline. Atherosclerosis 1997; 134:188-189.
Stosić-Grujicić SD, Maksimović DD, Stojković MB, Lukić ML. Pentoxifylline prevents autoinmune mediated inflammation in low dose streptozotocin induced diabetes. Dev Immunol 2001; 8:213-21
Liang L, Beshay E. The phosphodiesterase inhibitors pentoxifylline and rolipram prevents diabetes in NOD mice. Diabetes 1998; 47:570–575
Visser J, Groen H, Klatter F, Rozing J. Timing of pentoxifylline treatment determines its protective effect on diabetes development in the Bio Breeding rat. Eur J Pharmacol 2002; 445:133-40
Arias AM, Bisschop PH, Ackermans MT, Nijpels G, Endert E, Romijn JA, et al. Aminophyilline stimulates insulin secretion in patients with type 2 diabetes mellitus. Metabolism 2001; 50:1030-35.
Chen M, Yang Z, Wu R and Nadler JL. Lisofylline, a novel antiinflammatory agent, protects pancreatic beta-cells from proinflammatory cytokine damage by promoting mitocondrial metabolism. Endocrinology 2002; 143:2341-8.
Hotamisligil GS, Arner P, Caro JF, Atkinson RL, and Spiegelman BM. Increased Adipose tissue expression of tumor necrosis factor-alpha in human obesity and insulin resistance. J Clin Invest 1995; 95:2409-15.
Jones C, Abbasi F, Carantoni M, Polonsky KS, and Reaven GM. Roles of insulin resistance and obesity in regulation of plasma insulin concentrations. Am J Physiol Endocrinol Metab 2000; 278: E501–E508.
Matthews DR , Hosker JP, Rudenski AS, Naylor BA, Treacher DF and Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man (comment): Diabetologia 1985; 8:12-9.
DeFronzo RA, Tobin JD, and Andres R. Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol Endocrinol Metab 1979:237; E214-23.
Bonora E, Targher G, Alberiche M, Bonadonna RC. Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity. Diabetes Care 2000; 23:57-63.
Kern PA. Ranganathan S. Li C. Wood L. Ranganathan G. Adipose tissue tumor necrosis factor and interleukin-6 expression in human obesity and insulin resistance. Am J Physiol Endocrinol Metab 2001; 280:E745-51.
Kueszmarskib RJ, Flegal KM. Criteria for definition of overweight in transition:background and recommendations for the United States. Am J Clin Nutr 2000; 72:1074-1081.
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003; 42:1206.
East HH, Hicks G S, Low AK, Bouldin MJ, Russell Lori D, Friedrich CA, Brown C. An Internist´s Update on Cholesterol Management (Symposium). Am J Med Sci 2002; 324:189-195.
Kuzuya T, Nakagawa S, Satoh J, Kanazawa Y. Report of the Committee on the classification and diagnostic criteria of diabetes mellitus. Diabetes Research and Clinical Practice 2002; 55:65-85.
Rodríguez-Moran M, Guerrero-Romero F. Insulin resistance is independently related to age in Mexican women. J Endocrinol Invest 2003; 26:42-8.
Lawrence C. Hamilton. Statistics with Stata 6
Arias AMP, Bisschop PH, Ackermans MT, Nijpels G. Aminophylline stimulates insulin secretion in patients with type 2 diabetes mellitus. Metabolism 2001; 50:1030-1035.
MacKenzie T, Comi R, Sluss P, Keisari R, Manwar S, Kim J, et al Metabolic and hormonal effects of caffeine: randomized, double-blind, placebo-controlled crossover trial. Metabolism 2007; 56:1694-8
Robinson LE, Savani S, Battram DS, McLaren DH, Sathasivam P, Graham TE. Caffeine ingestion before an oral glucose tolerance test impairs blood glucose management in men with type 2 diabetes. J Nutr 2004; 134:2528-33
Satapathy SK, Garg S, Chauhan R, Sakhuja P, Malhotra V, Sharma BC, et al. Beneficial effects of tumor necrosis factor-alpha inhibition by pentoxifylline on clinical, biochemical, and metabolic parameters of patients with nonalcoholic steatohepatitis. Am J Gastroenterol 2004; 99:1946-52.
Yang Z, Chen M, Carter JD, Ellett JD, Smith KM, Nadler JL. Inflammation blockade improves pancreatic islet function. Transplant Proc 2004; 36:2864-5
Yang Z, Chen M, Ellett JD, Carter JD, Brayman KL, Nadler JL. Inflammatory blockade improves human pancreatic islet function and viability. Am J Transplant 2005; 5:475-83
Carroll JS, Ku CJ, Karunarathne W, Spence DM. Red blood cell stimulation of platelet nitric oxide production indicated by quantitative monitoring of the communication between cells in the bloodstream. Anal Chem 2007; 79:5
Godsland IF, Stevenson JC. Insulin resistance: Syndrome o tendency? Lancet 1995; 346:100-3.
Ariza CR, Fratti A, Gomez G, Almazan A. Hyperinsulinemia in patients with Coronary Heart Disease in Absence of Overt Risk Factors. Arch Med Res 1997; 28:115-119.