The acute effects of HIV protease inhibitors on insulin suppression of glucose production in healthy HIV-negative men.
BACKGROUND
The effects of different HIV protease inhibitors (PIs) on peripheral insulin resistance have been described, but less is known about their effects on insulin suppression of endogenous glucose production (EGP).


METHODS
We tested the acute effects of 3 PIs, indinavir, ritonavir, and amprenavir, on EGP quantified by stable isotope techniques during the hyperinsulinemic, euglycemic clamp in 3 similar placebo-controlled protocols.


RESULTS
EGP was higher with indinavir in the hyperinsulinemic state than with placebo (4.1 +/- 1.3 vs. 2.2 +/- 0.8 microg x kg(-1) x min(-1), P = 0.04). A trend toward higher EGP was seen with ritonavir (3.6 +/- 0.3 vs. 3.0 +/- 0.5 microg x kg(-1) x min(-1), P = 0.08). There was no evidence that amprenavir blunted insulin suppression of EGP compared with placebo (2.9 +/- 0.04 vs. 3.2 +/- 0.7 microg x kg(-1) x min(-1), P = 0.63).


CONCLUSIONS
Some PIs can acutely blunt the ability of insulin to suppress EGP, but, as with insulin resistance, the effects of PIs on EGP are drug-specific, not class-specific.
Lee
Grace A
GA
Department of Medicine, University of California, San Francisco, CA, USA.
Schwarz
Jean-Marc
JM
Patzek
Sophie
S
Kim
Seungki
S
Dyachenko
Artem
A
Wen
Michael
M
Mulligan
Kathleen
K
Schambelan
Morris
M
Grunfeld
Carl
C
D002219:Carbamates / Q000009:adverse effects*; D005663:Furans; D005947:Glucose / Q000378:metabolism*; D017320:HIV Protease Inhibitors / Q000009:adverse effects*; D006805:Human Experimentation; D006801:Humans; D019469:Indinavir / Q000009:adverse effects*; D007328:Insulin / Q000378:metabolism*; D008297:Male; D010919:Placebos / Q000008:administration & dosage; D019438:Ritonavir / Q000009:adverse effects*; D013449:Sulfonamides / Q000009:adverse effects*
D002219:Carbamates; D005663:Furans; D017320:HIV Protease Inhibitors; D007328:Insulin; D010919:Placebos; D013449:Sulfonamides; C095108:amprenavir; D019469:Indinavir; D005947:Glucose; D019438:Ritonavir
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