目的:尽管已知α-肾上腺素能受体拮抗剂对葡萄糖代谢等代谢参数具有积极作用,血脂谱,和胰岛素敏感性,目前还不清楚这是否是一种阶级效应。据报道,坦索罗辛对葡萄糖代谢和胰岛素抵抗有不良影响,这可能是因为与其他具有糖酵解增强作用的α-肾上腺素受体拮抗剂如多沙唑嗪相比,它缺乏糖酵解增强作用,特拉唑嗪,和阿夫佐辛.这项研究的目的是比较坦索罗辛与另一种α-1肾上腺素能受体拮抗剂对代谢参数的影响,多沙唑嗪.
方法:在此前瞻性中,观察,控制,12周临床研究,共有60名年龄≥40岁的男性患者首次开始服用坦索罗辛(n=30;0.4mg/天,口服;平均年龄,59.20±8.97岁)或多沙唑嗪(n=30;4或8毫克/天,口服;平均年龄,纳入良性前列腺增生(BPH)或下尿路症状(LUTS)的58.50±8.93年)。根据人体测量和生化参数(血糖,血脂谱,和胰岛素敏感性)在治疗结束时。
结果:在组内分析中,收缩压,舒张压,总胆固醇,与基线相比,多沙唑嗪组的HbA1c水平显着降低(均p<0.05),而坦索罗辛组未观察到显著变化。在组间比较中,收缩压,总胆固醇,与坦索罗辛组相比,多沙唑嗪组的低密度脂蛋白胆固醇水平显着降低(百分比变化:-6.68±13.08vs.0.53±11.02,p=0.025;-3.63±9.56vs.4.02±10.86,p=0.005;-5.62±18.18vs.5.24±15.42,p=0.015)。
结论:尽管这些结果不支持先前的发现,坦索罗辛对代谢参数有不良影响,他们提示,对于伴有代谢紊乱的BPH或LUTS患者,多沙唑嗪治疗可能是首选的一个原因.
OBJECTIVE: Although it is known that alpha-adrenergic receptor antagonists have positive effects on metabolic parameters such as glucose metabolism, lipid profile, and insulin sensitivity, it is unclear whether this is a class effect. Tamsulosin is reported to have adverse effects on glucose metabolism and insulin resistance, and this may be because of its lack of glycolysis-enhancing effect compared with other alpha-adrenergic receptor antagonists with glycolysis-enhancing effects such as
doxazosin, terazosin, and alfuzosin. The aim of this study was to compare the effect of tamsulosin on metabolic parameters with another alpha-1 adrenergic receptor antagonist,
doxazosin.
METHODS: In this prospective, observational, controlled, 12-week clinical study, a total of 60 male patients aged ≥ 40 years who were first started on tamsulosin (n = 30; 0.4 mg/day, oral; mean age, 59.20 ± 8.97 years) or
doxazosin (n = 30; 4 or 8 mg/day, oral; mean age, 58.50 ± 8.93 years) for benign prostatic hyperplasia (BPH) or lower urinary tract symptoms (LUTS) were enrolled. The groups were compared according to the changes in anthropometric and biochemical parameters (glycemia, lipid profile, and insulin sensitivity) at the end of treatment.
RESULTS: In intragroup analyses, systolic blood pressure, diastolic blood pressure, total cholesterol, and HbA1c levels decreased significantly in the
doxazosin group compared with baseline (p < 0.05 for all), while no significant change was observed in the tamsulosin group. In comparisons between groups, systolic blood pressure, total cholesterol, and low-density lipoprotein cholesterol levels showed a significant decrease in the
doxazosin group compared with the tamsulosin group (percent change: - 6.68 ± 13.08 vs. 0.53 ± 11.02, p = 0.025; - 3.63 ± 9.56 vs. 4.02 ± 10.86, p = 0.005; and - 5.62 ± 18.18 vs. 5.24 ± 15.42, p = 0.015, respectively).
CONCLUSIONS: Although these results do not support previous findings that tamsulosin has adverse effects on metabolic parameters, they suggest that doxazosin treatment may be a reason for preference in patients with BPH or LUTS accompanied by metabolic disorder.