不同糖负荷下阿卡波糖对2型糖尿病患者血清肠促胰岛素水平的影响  

Effects of Acarbose on incretins in newly diagnosed type 2 diabetic patients in different carbohydrate tolerance test

作　　者：傅晓莹[1] 陈红梅[1] 陈达强[2] 李忠文[1] 邝建[1] 

机构地区：[1]广东省医学科学院,广东省人民医院内分泌科,广州510080 [2]广东省医学科学院,广东省人民医院医学检验中心,广州510080

出　　处：《中国糖尿病杂志》2016年第12期1076-1081,共6页Chinese Journal of Diabetes

基　　金：中华医学会临床医学科研专项资金项目(12030520352)

摘　　要：目的在不同食物负荷情况下,观察阿卡波糖对T2DM患者血清胰升糖素样肽-1(GLP-1)和抑胃肽(GIP)水平的影响。方法新诊断T2DM患者32例,随机分为OGTT组和混合餐试验(MIX)组,使用阿卡波糖片治疗共6周。在服药前1周、第一次服药及治疗6周后行OGTT或MIX,试验时检测0、15、30、60、90、120 min PG、GIP、GLP-1。结果(1)OGTT组与MIX组均随机入组16例,平均年龄分别为(51.7±10.4)、(51.8±11.7)岁。(2)首次使用阿卡波糖治疗,MIX组负荷后PG、GIP均有下降,其中15、30、60、90、120 min PG,15、30、60、90 min GIP,PG、GIP曲线下面积(AUC)比较,差异有统计学意义(P<0.05);MIX组90 min GLP-1较治疗前升高(P<0.05)。OGTT组各点PG、GLP-1、GIP水平及AUC与治疗前比较,差异无统计学意义。(3)治疗6周后,MIX组负荷后PG较治疗前下降,GIP水平随着PG下降,在15、30、60、90 min时较治疗前下降(P<0.05)。MIX组90 min GLP-1较治疗前升高(P<0.05)。OGTT组各点GLP-1、GIP水平及AUC与治疗前比较,差异无统计学意义。结论在不同种类糖负荷下,阿卡波糖对肠促胰岛素的影响可能不同。在复合碳水化合物负荷下,阿卡波糖可能影响GLP-1晚相分泌水平,而GIP可随PG水平的下降而降低。Objective To evaluate the effects of Acarbose on incretin level （glucagon-like peptide 1 （GLP-1） and gastric inhibitory polypeptide（GIP） of type 2 diabetes mellitus （T2DM） patients after different kinds of glucose load. Methods A total of 32 newly diagnosed T2DM patients were enrolled in this study and randomly divided into two groups： oral glucose tolerance group（OGTT group） and mixed meal group（MIX group）. AU the subjects were treated with Acarbose for 6 weeks. The glucose tolerance tests were conducted one week before treatment, after the initial prescription and after six-week treatment, respectively. Plasma glucose（PG）,GLP-1 and GIP at 0,15,30,60,90,120 rain were tested. Results （1） 16 patients were randomly enrolled in each group, the average age was （51.7±10. 4） and （51.8 ± 11.7） years old in OGTT group and MIX group respectively. （2）After the initial prescription,PG and GIP decreased in MIX group. The AUC of PG at 15,30,60,90,120 min and the GIlD at 15,30,60,90 min had significantly difference（P〈0. 05）, and the GLP-1 level at 90 rain was significantly increased（P〈0. 05）. PG,GIP and GLP-1 had no statistic difference before and after treatment in OGTT group. （3）The levels of postprandial PG and GIP in MIX group were lower after six-week treatment, the GIP at 15,30,60,90 rain had significant difference（P〈0. 05）, 90 rain GLP-1 was significantly higher after treatment （P〈0. 05）. The AUC of GIP and GLP-1 had no statistic difference between before and after treatment in CTTgroup. Conclusion The effects of Acarbose on the levels of incretins of T2DM patients may vary with different types of glucose load. In mixed meal load, Acarbose influenced GLP-1 secretion in late phase, and GIP is reduced together with the decrease of PG.

关 键 词：糖尿病 2型 肠促胰岛素 胰升糖素样肽-1 抑胃肽 阿卡波糖 

分 类 号：R587.1[医药卫生—内分泌]