不同饮食负荷对葡萄糖依赖性促胰岛素分泌多肽的影响  

Effect of different dietary loads on glucose-dependent insulinotropic polypeptide in subjects with normal glucose tolerance

作　　者：陈重[1] 严励[2] 傅晓莹[1] 杨华章[1] 邝建[1] 

机构地区：[1]广东省人民医院/广东省医学科学院内分泌科,广东广州510080 [2]中山大学附属第二医院内分泌科,广东广州510120

出　　处：《南方医科大学学报》2011年第12期2031-2034,共4页Journal of Southern Medical University

基　　金：广东省中医药局科研课题计划(2009115);广东省医学科研基金(A2010027);广东省科技计划(2010B031600171)

摘　　要：目的探讨不同饮食负荷对正常糖耐量人群的葡萄糖依赖性促胰岛素分泌多肽(glucose-dependent insulinotropicploypeptide,GIP)分泌模式的影响,及其与胰岛素分泌、血浆葡萄糖水平的关系。方法 14例正常糖耐量受试者先后接受75 g葡萄糖耐量及混合餐耐量试验,检测空腹及葡萄糖或混合餐后15,30,60,90和120 min的血糖、胰岛素及GIP。结果(1)葡萄糖负荷后GIP的第一个峰值在糖负荷后15 min(45.09±4.67)pmol/L,短暂下降之后持续上升至120 min(59.66±11.73)pmol/L;(2)混合餐负荷后GIP分泌呈双时相曲线,第一峰值在15 min(71.69±14.19)pmol/L,显著高于同时点的葡萄糖负荷(P<0.05);第二个峰在90 min(55.35±13.19)pmol/L。两种饮食负荷后GIP曲线下面积无统计学差异(P>0.05);(3)随着混合餐负荷时GIP早期分泌(15 min)第一峰值升高幅度较葡萄糖负荷大,胰岛素达峰时间提前(30 min vs 60min),同时混合餐负荷后15 min血糖升高幅度明显低于葡萄糖负荷(P<0.05)。结论正常糖耐量人群两种饮食负荷后GIP分泌曲线明显不同,混合餐后GIP分泌呈典型的双相分泌,其第一峰值显著高于葡萄糖负荷,提示混合餐(含脂肪)刺激GIP释放较强,使胰岛素达峰时间提前,可能是混合餐血糖峰值较低的重要原因之一。Objective To investigate the secretion patterns of glucose-dependent insulinotropic polypeptide（GIP） after different dietary loads in subjects with normal glucose tolerance（NGT） and their relation to insulin secretion and plasma glucose levels.Methods Fourteen subjects with normal glucose tolerance underwent 75 g glucose tolerance test（OGTT） followed by mixed meal tolerance test（MMT） one week later.Blood glucose,insulin,and GIP were measured in the fasting state and at 0,15,30,60,90 and 120 min after glucose load or mixed meal load.Results The first peak value of GIP after glucose load occurred at 15 min（45.09±4.67 pmol/L）.After a brief decline,GIP continued to increase till reaching 59.66±11.73 pmol/L at 120 min after the load.After the mixed meal load,GIP secretion presented with two peaks： the first peak appeared at 15 min（71.69±14.19 pmol/L） with a level significantly higher than that at 15 min following glucose load（P0.05）,and the second occurred at 90 min（55.35±13.19 pmol/L）.The area under curve of GIP showed no significant difference between the two loads（P0.05）.Compared with glucose load,mixed meal load resulted in an increase of the first GIP peak and an earlier insulin peak（30 min vs 60 min）,but a significant decrease of blood glucose at 15 min（P0.05）.Conclusion Compared with glucose load,mixed meal（containing fat） can strongly stimulate GIP release and cause earlier occurrence of the insulin peak,which might be an important reason for the lower blood glucose after mixed meal.

关 键 词：正常糖耐量 肠促胰岛素 葡萄糖依赖性促胰岛素分泌多肽 

分 类 号：R587.1[医药卫生—内分泌]