Effects of epalrestat, an aldose reductase inhibitor, on diabetic neuropathy and gastroparesis

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概要

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• Objective Diabetic patients with severe autonomic nervous disorder show delayed gastric emptying accompanied by diabetic gastroparesis, which decreases the electric activity of the stomach associated with gastric motility. It is reported that epalrestat, an aldose reductase inhibitor, is useful for treating diabetic neuropathy. Therefore, we evaluated whether this drug improves the decreased gastric motility in diabetic patients. Methods The present study evaluated the electrogastrograms (EGG) and autonomic nervous activity in 15 healthy volunteers (N group), and in 15 diabetic patients before and after the administration of epalrestat (DM group). Autonomic nervous activity was evaluated by spectral analysis of heart rate variability. The EGGs were recorded before and after oral administration of epalrestat (3 months or more) in the DM group. Results The dominant frequency of EGG was 3 cycles/min (cpm) in the N group. However, these 3 cpm waves disappeared with bradygastria, and postprandial increases in the peak powers of EGG were not observed in the DM group. Both the amplitude of 3 cpm waves and the postprandial peak powers were significantly increased after the administration of epalrestat. The parameters of autonomic nervous activities (LF power, HE power, and the LF/HF ratio) were significantly lower in the DM group before the administration of epalrestat than in the N group. However, these parameters were improved after the administration of epalrestat. Conclusion Since gastroparesis is a form of diabetic dysautonomia, complication by gastroparesis may influence blood sugar control and the absorbance of oral antidiabetics. Epalrestat significantly increased the amplitude of 3 cpm waves on EGG and improved the spectral analytical parameters of heart rate variability. These findings suggest that epalrestat is useful for the treatment of diabetic gastroparesis.(Internal Medicine 42: 655-664, 2003)

• 社団法人　日本内科学会の論文

著者

• Okamoto H

  Department Of Advanced Materials Science And Engineering Faculty Of Engineering Yamaguchi University

• Kimura M

  Department Of Applied Physics Faculty Of Engineering Ehime University

• Nakaya Y

  Department Of Nutrition And Metabolism Institute Of Health Biosciences The University Of Tokushima G

• Nomura M

  Department Of Applied Chemistry Faculty Of Engineering Osaka University

• Chikamori K

  Department Of Chemistry Naruto University Of Education

• Ito S

  Deparetment Of Internal Medicine (ii) Niigata University School Ofmedicine

• Saito K

  Department Of Analytical Chemistry Faculty Of Pharmaceutical Sciences Hoshi University

• Uehara K

  Department Of Bioresources Chemistry Faculty Of Horticulture Chiba University

• OKAMOTO Hiroshi

  Department of Internal Medicine, Kochi Red Cross Hospital

• ITO Susumu

  Department of Digestive and Cardiovascular Medicine, School of Medicine, University of Tokushima

• NOMURA Masahiro

  Department of Digestive and Cardiovascular Medicine, School of Medicine, University of Tokushima

• NAKAYA Yutaka

  Department of Nutrition, School of Medicine, University of Tokushima

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