JCEM:低剂量格列齐特对肠促胰岛素作用和β细胞功能的影响

2021-03-12 MedSci原创 MedSci原创

低剂量格列齐特可降低血糖,并同时增强经典肠促胰岛素的效应。β细胞模型显示,低浓度的血浆格列齐特增强晚期胰岛素分泌,并增加50%的葡萄糖敏感性。

新生儿糖尿病研究表明磺脲类降糖药可以在不引起低血糖的情况下降低血糖,部分原因是增强了肠促胰岛素的效应。这一机制以前从未被认为与2型糖尿病(T2DM)患者服用的磺脲类药物有关。

近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,研究人员旨在评估低剂量格列齐特对T2DM患者β细胞功能和肠促胰岛素效应的影响。

研究人员对16名接受饮食或二甲双胍单药治疗的2型糖尿病(HbA1c<64mmol/mol,8.0%)患者进行了配对口服糖耐量试验和等血糖输注,以评估接受和不接受低剂量格列齐特治疗的经典肠促胰岛素效应的差异。研究人员采用细胞功能模型来描述胰岛素分泌和葡萄糖浓度之间的关系。

单剂量20mg格列齐特将OGTT期间的平均血糖浓度从12.01±0.56降低到10.82±0.5 mmol/l (p=0.0006)(平均值±SEM)。20mg格列齐特使经典肠促胰岛素效应由35.5% (LQ为27.3, UQ为61.2)增强到54.99% (34.8,72.8)(p=0.049)。格列齐特使β细胞葡萄糖敏感性提高了46%(对照组为22.61±3.94,格列齐特组为33.11±7.83 (p=0.01)),此外,晚期肠促胰岛素分泌增强(对照组为0.92±0.05,格列齐特组为1.285±0.14 (p=0.038))。

由此可见,低剂量格列齐特可降低血糖,并同时增强经典肠促胰岛素的效应。β细胞模型显示,低浓度的血浆格列齐特增强晚期胰岛素分泌,并增加50%的葡萄糖敏感性。低剂量格列齐特是否能通过增强肠促胰岛素的效应而有效降低血糖而不发生低血糖的风险,值得进一步研究。

原始出处:

Ruth L M Cordiner.et al.The impact of low dose gliclazide on the incretin effect and indices of beta cell function.JCEM.2021.https://doi.org/10.1210/clinem/dgab151

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    2021-11-29 smallant2015
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    2022-01-18 achengzhao
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createdName=zy&kt, createdTime=Sat Apr 03 00:20:02 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1750208, encodeId=a2f91e5020827, content=<a href='/topic/show?id=be7c8385345' target=_blank style='color:#2F92EE;'>#胰岛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83853, encryptionId=be7c8385345, topicName=胰岛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a7a536274692, createdName=baoya, createdTime=Fri Feb 25 07:51:37 CST 2022, time=2022-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=949925, encodeId=cf7f949925bf, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=51705231149, createdName=1479ea96m27暂无昵称, createdTime=Sun Mar 21 16:31:44 CST 2021, time=2021-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480595, encodeId=c120148059570, content=<a href='/topic/show?id=647d2615939' target=_blank style='color:#2F92EE;'>#低剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26159, encryptionId=647d2615939, topicName=低剂量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=97b17641126, createdName=ms1292405679162969, createdTime=Sun Mar 14 12:51:37 CST 2021, time=2021-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551625, encodeId=3521155162580, content=<a href='/topic/show?id=2c838152309' target=_blank style='color:#2F92EE;'>#肠促胰岛素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81523, encryptionId=2c838152309, topicName=肠促胰岛素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5d514195798, createdName=Boyinsh, createdTime=Sun Mar 14 12:51:37 CST 2021, time=2021-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1586859, encodeId=ec21158685970, content=<a href='/topic/show?id=a6d1e7821de' target=_blank style='color:#2F92EE;'>#细胞功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77821, encryptionId=a6d1e7821de, topicName=细胞功能)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ec517387980, createdName=般若傻瓜, createdTime=Sun Mar 14 12:51:37 CST 2021, time=2021-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1618916, encodeId=aef61618916fe, content=<a href='/topic/show?id=007419239ca' target=_blank style='color:#2F92EE;'>#β细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19239, encryptionId=007419239ca, topicName=β细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b69919964433, createdName=ms24272190615788285182, createdTime=Sun Mar 14 12:51:37 CST 2021, time=2021-03-14, status=1, ipAttribution=)]
    2021-04-03 zy&kt

    有用,谢谢!

    0

  5. 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createdBy=70fe497, createdName=paperyu, createdTime=Mon Jan 24 18:51:37 CST 2022, time=2022-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2063411, encodeId=bba92063411d9, content=<a href='/topic/show?id=14fb10264d7' target=_blank style='color:#2F92EE;'>#JCE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10264, encryptionId=14fb10264d7, topicName=JCE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e656479, createdName=achengzhao, createdTime=Tue Jan 18 22:51:37 CST 2022, time=2022-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=953432, encodeId=287895343277, content=有用,谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=46905128057, createdName=zy&kt, createdTime=Sat Apr 03 00:20:02 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1750208, encodeId=a2f91e5020827, content=<a href='/topic/show?id=be7c8385345' target=_blank style='color:#2F92EE;'>#胰岛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83853, encryptionId=be7c8385345, topicName=胰岛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a7a536274692, createdName=baoya, createdTime=Fri Feb 25 07:51:37 CST 2022, time=2022-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=949925, encodeId=cf7f949925bf, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=51705231149, createdName=1479ea96m27暂无昵称, createdTime=Sun Mar 21 16:31:44 CST 2021, time=2021-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480595, encodeId=c120148059570, content=<a href='/topic/show?id=647d2615939' target=_blank style='color:#2F92EE;'>#低剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26159, encryptionId=647d2615939, topicName=低剂量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=97b17641126, createdName=ms1292405679162969, createdTime=Sun Mar 14 12:51:37 CST 2021, time=2021-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551625, encodeId=3521155162580, content=<a href='/topic/show?id=2c838152309' target=_blank style='color:#2F92EE;'>#肠促胰岛素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81523, encryptionId=2c838152309, topicName=肠促胰岛素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e5d514195798, createdName=Boyinsh, createdTime=Sun Mar 14 12:51:37 CST 2021, time=2021-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1586859, encodeId=ec21158685970, content=<a href='/topic/show?id=a6d1e7821de' target=_blank style='color:#2F92EE;'>#细胞功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77821, encryptionId=a6d1e7821de, topicName=细胞功能)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ec517387980, createdName=般若傻瓜, createdTime=Sun Mar 14 12:51:37 CST 2021, time=2021-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1618916, encodeId=aef61618916fe, content=<a href='/topic/show?id=007419239ca' target=_blank style='color:#2F92EE;'>#β细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19239, encryptionId=007419239ca, topicName=β细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b69919964433, createdName=ms24272190615788285182, createdTime=Sun Mar 14 12:51:37 CST 2021, time=2021-03-14, status=1, ipAttribution=)]
    2022-02-25 baoya
  6. 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createdTime=Sun Mar 21 16:31:44 CST 2021, time=2021-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480595, encodeId=c120148059570, content=<a href='/topic/show?id=647d2615939' target=_blank style='color:#2F92EE;'>#低剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26159, encryptionId=647d2615939, topicName=低剂量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=97b17641126, createdName=ms1292405679162969, createdTime=Sun Mar 14 12:51:37 CST 2021, time=2021-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551625, encodeId=3521155162580, content=<a href='/topic/show?id=2c838152309' target=_blank style='color:#2F92EE;'>#肠促胰岛素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81523, encryptionId=2c838152309, 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likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=19239, encryptionId=007419239ca, topicName=β细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b69919964433, createdName=ms24272190615788285182, createdTime=Sun Mar 14 12:51:37 CST 2021, time=2021-03-14, status=1, ipAttribution=)]
    2021-03-21 1479ea96m27暂无昵称

    学习

    0

  7. 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createdTime=Sun Mar 21 16:31:44 CST 2021, time=2021-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480595, encodeId=c120148059570, content=<a href='/topic/show?id=647d2615939' target=_blank style='color:#2F92EE;'>#低剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26159, encryptionId=647d2615939, topicName=低剂量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=97b17641126, createdName=ms1292405679162969, createdTime=Sun Mar 14 12:51:37 CST 2021, time=2021-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1551625, encodeId=3521155162580, content=<a href='/topic/show?id=2c838152309' target=_blank style='color:#2F92EE;'>#肠促胰岛素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81523, encryptionId=2c838152309, 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  8. 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