Avignon A, Lapinski H, Rabasa-Lhoret R, Caubel C, Boniface H, Monnier L
Department of Metabolic Diseases, Lapeyronie Hospital, Montpellier, France.
Diabetes Obes Metab. 2000 Aug;2(4):229-35. doi: 10.1046/j.1463-1326.2000.00082.x.
To compare substrates oxidative patterns in type 2 diabetic patients treated with sulphonylurea alone or in combination with metformin.
Plasma glucose (PG), plasma insulin (PI) and substrates oxidation rates measured by indirect calorimetry were compared during a test day at 8.00 a.m. (before breakfast), 11.00 a.m. (before the lunch), 2.00 p.m. (2 h after the lunch) and at 5.00 p.m. in 56 diabetic patients treated with diet (group C, n = 14), sulphonylurea (group S, n = 14) or with a sulphonylurea-metformin combination (group SM, n = 28).
The three groups were comparable for age, body mass index (b.m.i.), body composition and PG levels. Mean glucose oxidation (Gox) was increased since mean lipid oxidation (Lox) was decreased in group S in comparison both with group C (3.02+/-0.08 vs. 2.62+/-0.08 g/min/kg/10(3), p < 0.05; 0.53+/-0.04 vs. 0.88+/-0.09 g/min/kg/10(3), p < 0.01). Mean Lox was also decreased in group S in comparison with group SM (0.88+/-0.06 vs. 0.53+/-0.04 g/min1/kg1/10(3), p < 0.0001) whereas the difference in Gox between these latter two groups was only significant in the basal state (1.94+/-0.17 vs. 2.47+/-0.17 g/min1/kg1/10(3), p < 0.05). Mean respiratory quotient (RQ) was increased in group S (0.90+/-0.01) in comparison both with group C (0.86+/-0.01, p < 0.001) and with group SM (0.86+/-0.01, p < 0.001). Mean energy expenditure was lower in group S than in group SM (21.4+/-0.6 vs. 23.6+/-0.6 kcal/min/kg/10(3), p < 0.05). Substrates oxidative patterns, RQ values and energy expenditure were similar in group C and in group SM.
When compared to patients treated with a sulphonylurea-metformin bitherapy, patients treated with a sulphonylurea monotherapy have a shift in their ratio of fat to carbohydrate oxidation that could make body weight loss more difficult in this latter group.
比较单独使用磺脲类药物或联合二甲双胍治疗的2型糖尿病患者的底物氧化模式。
在上午8点（早餐前）、上午11点（午餐前）、下午2点（午餐后2小时）和下午5点，对56例接受饮食治疗的糖尿病患者（C组，n = 14）、接受磺脲类药物治疗的患者（S组，n = 14）或接受磺脲类药物 - 二甲双胍联合治疗的患者（SM组，n = 28），通过间接测热法测量的血浆葡萄糖（PG）、血浆胰岛素（PI）和底物氧化率进行比较。
三组在年龄、体重指数（b.m.i.）、身体成分和PG水平方面具有可比性。与C组相比，S组的平均葡萄糖氧化（Gox）增加，平均脂质氧化（Lox）降低（3.02±0.08 vs. 2.62±0.08 g/min/kg/10³，p < 0.05；0.53±0.04 vs. 0.88±0.09 g/min/kg/10³，p < 0.01）。与SM组相比，S组的平均Lox也降低（0.88±0.06 vs. 0.53±0.04 g/min1/kg1/10³，p < 0.0001），而后两组之间的Gox差异仅在基础状态下显著（1.94±0.17 vs. 2.47±0.17 g/min1/kg1/10³，p < 0.05）。与C组（0.86±0.01，p < 0.001）和SM组（0.86±0.01，p < 0.001）相比，S组的平均呼吸商（RQ）增加。S组的平均能量消耗低于SM组（21.4±0.6 vs. 23.6±0.6 kcal/min/kg/10³，p < 0.05）。C组和SM组的底物氧化模式、RQ值和能量消耗相似。
与接受磺脲类药物 - 二甲双胍联合治疗的患者相比，接受磺脲类药物单药治疗的患者脂肪与碳水化合物氧化比例发生变化，这可能使后一组患者体重减轻更加困难。
