Hücking K, Kostic Z, Pox C, Ritzel R, Holst J J, Schmiegel W, Nauck M A
Medizinische Universitätsklinik, Knappschaftskrankenhaus Bochum (Langendreer) Germany.
Diabet Med. 2005 Apr;22(4):470-6. doi: 10.1111/j.1464-5491.2005.01451.x.
Acarbose is able to enhance GLP-1 release and delay gastric emptying in normal subjects. The effect of alpha-glucosidase inhibition on GLP-1 has been less evident in Type 2 diabetic patients. The aim of this study was to investigate the possible influence of acarbose on GLP-1 release and gastric emptying in Type 2 diabetic patients after a mixed test meal.
Ten Type 2 diabetic patients were tested with 100 mg acarbose or placebo served with a mixed meal that was labelled with 100 mg 13C-octanoic acid. Plasma concentrations of glucose, insulin, C-peptide, glucagon, GLP-1 and GIP were determined over 6 h. Gastric emptying was measured by determining breath 13CO2 using infrared absorptiometry. Statistics repeated-measures anova.
Gastric emptying rates (t1/2: 162 +/- 45 vs. 163 +/- 62 min, P = 0.65) and plasma concentrations (increasing from approximately 12 to approximately 25 pmol/l, P = 0.37) and integrated responses of GLP-1 (P = 0.37) were not changed significantly by acarbose treatment. Postprandial plasma glucose concentrations (P < 0.0001) and their integrated responses were lowered by acarbose (by 64%; P = 0.016). The plasma concentrations of insulin and C-peptide were reduced (P = 0.007 and 0.057, respectively) by acarbose, while glucagon was not changed (P = 0.96). GIP plasma concentrations (increasing with placebo from approximately 10 to approximately 85 pmol/l and with acarbose to approximately 55 pmol/l (P < 0.0001) and their integrated responses were significantly lowered (by 43%) by acarbose (P = 0.021). After 2 weeks of acarbose treatment (50 mg t.i.d. for the first and 100 mg t.i.d. for the second week, n = 6), similar results were found.
In hyperglycaemic Type 2 diabetic patients, ingestion of acarbose with a mixed test meal failed to enhance GLP-1 release and did not influence gastric emptying.
阿卡波糖能够增强正常受试者体内胰高血糖素样肽-1（GLP-1）的释放并延缓胃排空。在2型糖尿病患者中，α-葡萄糖苷酶抑制作用对GLP-1的影响尚不明显。本研究旨在探讨混合试验餐后阿卡波糖对2型糖尿病患者GLP-1释放及胃排空的可能影响。
10例2型糖尿病患者分别服用100mg阿卡波糖或安慰剂，并同时进食标有100mg 13C-辛酸的混合餐。在6小时内测定血浆葡萄糖、胰岛素、C肽、胰高血糖素、GLP-1和胃抑肽（GIP）的浓度。通过红外吸收法测定呼出气体中的13CO2来测量胃排空情况。采用重复测量方差分析进行统计学分析。
阿卡波糖治疗对胃排空率（t1/2：162±45 vs. 163±62分钟，P = 0.65）、GLP-血浆浓度（从约12pmol/l增至约25pmol/l，P = 0.37）及其综合反应（P = 0.37）均无显著影响。阿卡波糖可降低餐后血浆葡萄糖浓度（P < 0.0001）及其综合反应（降低64%；P = 0.016）。阿卡波糖可降低胰岛素和C肽的血浆浓度（分别为P = 0.007和0.057），而胰高血糖素浓度无变化（P = 0.96）。阿卡波糖可使GIP血浆浓度（安慰剂组从约10pmol/l增至约85pmol/l，阿卡波糖组增至约55pmol/l，P < 0.0001）及其综合反应显著降低（降低43%，P = 0.021）。阿卡波糖治疗2周（第1周50mg每日3次，第2周100mg每日3次，n = 6）后，得到了相似的结果。
在血糖升高的2型糖尿病患者中，混合试验餐时服用阿卡波糖未能增强GLP-1释放，也未影响胃排空。
Zotero 插件