title: Effects of ritonavir and amprenavir on insulin sensitivity in healthy volunteers.
abstract: BACKGROUND
  Some HIV protease inhibitors (PIs) have been shown to induce insulin resistance in vitro but the degree to which specific PIs affect insulin sensitivity in humans is less well understood.
  
  
  METHODS
  In two separate double-blind, randomized, cross-over studies, we assessed the effects of a single dose of ritonavir (800 mg) and amprenavir (1200 mg) on insulin sensitivity (euglycemic hyperglycemic clamp) in healthy normal volunteers.
  
  
  RESULTS
  Ritonavir decreased insulin sensitivity (-15%; P = 0.008 versus placebo) and non-oxidative glucose disposal (-30%; P = 0.0004), whereas neither were affected by amprenavir administration.
  
  
  CONCLUSIONS
  Compared to previously performed studies of identical design using single doses of indinavir and lopinavir/ritonavir, a hierarchy of insulin resistance was observed with the greatest effect seen with indinavir followed by ritonavir and lopinavir/ritonavir, with little effect of amprenavir.
authors: Department of Medicine, University of California, San Francisco, California, USA. grace.lee.2@ucsf.edu
authors: Grace A
authors: GA
authors: Lee
authors: Madhu
authors: M
authors: Rao
authors: Kathleen
authors: K
authors: Mulligan
authors: Joan C
authors: JC
authors: Lo
authors: Francesca
authors: F
authors: Aweeka
authors: Jean-Marc
authors: JM
authors: Schwarz
authors: Morris
authors: M
authors: Schambelan
authors: Carl
authors: C
authors: Grunfeld
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002219:Carbamates / Q000494:pharmacology*; D004311:Double-Blind Method; D004734:Energy Metabolism; D005663:Furans; D015309:Glucose Clamp Technique; D017320:HIV Protease Inhibitors / Q000494:pharmacology*; D006801:Humans; D019469:Indinavir / Q000494:pharmacology; D007328:Insulin / Q000008:administration & dosage / Q000097:blood; D007333:Insulin Resistance; D019344:Lactic Acid / Q000097:blood; D061466:Lopinavir; D008297:Male; D008875:Middle Aged; D011744:Pyrimidinones / Q000494:pharmacology; D019438:Ritonavir / Q000494:pharmacology*; D013449:Sulfonamides / Q000494:pharmacology*
chemical_list: D001786:Blood Glucose; D002219:Carbamates; D005663:Furans; D017320:HIV Protease Inhibitors; D007328:Insulin; D011744:Pyrimidinones; D013449:Sulfonamides; D061466:Lopinavir; D019344:Lactic Acid; C095108:amprenavir; D019469:Indinavir; D019438:Ritonavir