Huang Zhen, Jansson Leif, Sjöholm Ake
Department of Internal Medicine, Karolinska Institutet, Stockholm South Hospital, SE 118 83 Stockholm, Sweden.
Clin Sci (Lond). 2007 Jan;112(1):69-76. doi: 10.1042/CS20060176.
Pravastatin, irbesartan and captopril are frequently used in the treatment of patients with Type 2 diabetes. These drugs also exert beneficial metabolic effects, causing an improved glucose tolerance in patients, but the precise mechanisms by which this is achieved remain elusive. To this end, we have studied whether these drugs influence insulin secretion in vivo through effects on islet blood perfusion. Captopril (3 mg/kg of body weight), irbesartan (3 mg/kg of body weight) and pravastatin (0.5 mg/kg of body weight) were injected intravenously into anaesthetized female Wistar rats. Blood flow rates were determined by a microsphere technique. Blood glucose concentrations were measured with test reagent strips and serum insulin concentrations were measured by ELISA. Pancreatic blood flow was markedly increased by pravastatin (P<0.001), captopril (P<0.05) and irbesartan (P<0.01). Pancreatic islet blood flow was significantly and preferentially enhanced after the administration of captopril (P<0.01), irbesartan (P<0.01) and pravastatin (P<0.001). Kidney blood flow was enhanced significantly by pravastatin (P<0.01), irbesartan (P<0.05) and captopril (P<0.01). Captopril and pravastatin also enhanced late-phase insulin secretion and positively influenced glycaemia in intraperitoneal glucose tolerance tests. In conclusion, the present study suggests that a local pancreatic renin-angiotensin system and pravastatin treatment may be selectively controlling pancreatic islet blood flow, augmenting insulin secretion and thereby improving glucose tolerance. Our findings indicate significant gender-related differences in the vascular response to these agents. Since statins and renin-angiotensin system inhibitors are frequently used by diabetic patients, the antidiabetic actions of these drugs reported previously might occur, in part, through the beneficial direct islet effects shown in the present study.
普伐他汀、厄贝沙坦和卡托普利常用于治疗2型糖尿病患者。这些药物还具有有益的代谢作用,可改善患者的糖耐量,但其实现这一作用的确切机制仍不清楚。为此,我们研究了这些药物是否通过影响胰岛血流在体内影响胰岛素分泌。将卡托普利(3毫克/千克体重)、厄贝沙坦(3毫克/千克体重)和普伐他汀(0.5毫克/千克体重)静脉注射到麻醉的雌性Wistar大鼠体内。通过微球技术测定血流速率。用测试试剂条测量血糖浓度,并用酶联免疫吸附测定法测量血清胰岛素浓度。普伐他汀(P<0.001)、卡托普利(P<0.05)和厄贝沙坦(P<0.01)可显著增加胰腺血流。给予卡托普利(P<0.01)、厄贝沙坦(P<0.01)和普伐他汀(P<0.001)后,胰腺胰岛血流显著且优先增加。普伐他汀(P<0.01)、厄贝沙坦(P<0.05)和卡托普利(P<0.01)可显著增加肾血流。在腹腔葡萄糖耐量试验中,卡托普利和普伐他汀还可增强晚期胰岛素分泌并对血糖产生积极影响。总之,本研究表明局部胰腺肾素-血管紧张素系统和普伐他汀治疗可能选择性地控制胰腺胰岛血流,增加胰岛素分泌,从而改善糖耐量。我们的研究结果表明这些药物的血管反应存在显著的性别差异。由于糖尿病患者经常使用他汀类药物和肾素-血管紧张素系统抑制剂,先前报道的这些药物的抗糖尿病作用可能部分是通过本研究中显示的有益的直接胰岛作用实现的。