Ioannidis I, Tsoukala C, Panayotopoulou C, Skrapari I, Maglara E, Anastasopoulou Y, Mandalaki T, Katsilambros N
1st Department of Propaedeutic Medicine, Athens University Medical School, Greece.
Nutr Metab Cardiovasc Dis. 1999 Aug;9(4):204-7.
Previous data indicate that even mild postprandial hyperglycaemia in diabetic subjects, who are concerned to be in good control, activates haemostasis. The aim of this study was to investigate the effect of the oral administration of 5 mg glibenclamide on postprandial activation of coagulation in type 2 diabetics.
We designed a placebo controlled, randomised study. After an overnight fast, each subject (n = 16, age 50-68 yr.) underwent a standard test meal (600 Kcal: carbohydrates 40%, lipids 50%, proteins 10%) preceded by one tablet of glibenclamide (5 mg) or placebo. The two tests were performed randomly, with an interval of 7 days. Blood samples were collected at baseline and 2 and 4 hours after the meal to measure the concentrations of glucose, insulin, c-peptide, triglycerides as well as of d-dimers, fibrinogen, F1.2 and TAT. The postprandial levels of TAT, fibrinogen, F1.2, d-dimers, insulin, glucose and triglycerides were significantly higher compared to baseline values.
The postprandial levels of glucose, triglycerides, fibrinogen, F1.2, TAT and d-dimers were lower after glibenclamide administration as compared to placebo, while the concentrations of insulin and c-peptide were higher. Thus, acute administration of glibenclamide reduces the postprandial activation of coagulation.
既往数据表明,即使是血糖得到较好控制的糖尿病患者出现轻度餐后高血糖,也会激活凝血功能。本研究旨在探讨口服5mg格列本脲对2型糖尿病患者餐后凝血激活的影响。
我们设计了一项安慰剂对照的随机研究。在禁食过夜后,每位受试者(n = 16,年龄50 - 68岁)在服用一片格列本脲(5mg)或安慰剂后,接受标准试验餐(600千卡:碳水化合物40%,脂质50%,蛋白质10%)。两次试验随机进行,间隔7天。在基线以及餐后2小时和4小时采集血样,以测量葡萄糖、胰岛素、C肽、甘油三酯以及D - 二聚体、纤维蛋白原、F1.2和凝血酶 - 抗凝血酶复合物(TAT)的浓度。与基线值相比,餐后TAT、纤维蛋白原、F1.2、D - 二聚体、胰岛素、葡萄糖和甘油三酯的水平显著升高。
与安慰剂相比,服用格列本脲后餐后葡萄糖、甘油三酯、纤维蛋白原F1.2、TAT和D - 二聚体的水平较低,而胰岛素和C肽的浓度较高。因此,急性给予格列本脲可降低餐后凝血激活。