Kiyici S, Ersoy C, Oz Gul O, Sarandol E, Demirci M, Tuncel E, Sigirli D, Erturk E, Imamoglu S
Department of Endocrinology and Metabolism, Uludag University, Medical Faculty, Bursa, Turkey.
Exp Clin Endocrinol Diabetes. 2009 Sep;117(8):386-90. doi: 10.1055/s-0029-1220936. Epub 2009 Jul 23.
Ghrelin, a potent gut-brain orexigenic peptide, has a role in stimulation of food intake and long-term regulation of body weight. Metformin and pioglitazone treatment have different effects on body weight. This discrepancy might be related with the effect of these two drugs on plasma ghrelin levels. We investigated the effect of these two drugs on post-prandial acylated and total ghrelin levels in patients with type 2 diabetes. Eleven patients treated with diet, 12 patients treated with 850 mg/day metformin monotherapy and 12 patients treated with 30 mg/day pioglitazone monotherapy for at least 6 months were enrolled in the study. Plasma acylated and total ghrelin levels were investigated at baseline and at the 60 (th), 120 (th), 180 (th), 240 (th) minutes after a mixed meal test. There were no differences between groups in any of baseline metabolic and anthropometric parameters, including acylated and total ghrelin levels. Acylated and total ghrelin concentrations were suppressed similarly after food consumption, and we could not determine any significant difference between the groups at any time interval. A prolonged postprandial suppression of acylated ghrelin concentrations was observed in the pioglitazone treatment group compared with baseline values. In conclusion, total and acylated ghrelin levels after a mixed meal test were similar in type 2 diabetic patients treated with metformin, pioglitazone or diet therapy alone. These results suggest that changes in body weight during metformin and pioglitazone treatment are not associated with plasma ghrelin levels.
胃饥饿素是一种强大的肠-脑促食欲肽，在刺激食物摄入和长期调节体重方面发挥作用。二甲双胍和吡格列酮治疗对体重有不同影响。这种差异可能与这两种药物对血浆胃饥饿素水平的影响有关。我们研究了这两种药物对2型糖尿病患者餐后酰化和总胃饥饿素水平的影响。该研究纳入了11名接受饮食治疗的患者、12名接受850毫克/天二甲双胍单药治疗的患者和12名接受30毫克/天吡格列酮单药治疗至少6个月的患者。在基线以及混合餐试验后第60、120、180、240分钟时检测血浆酰化和总胃饥饿素水平。各组在任何基线代谢和人体测量参数方面均无差异，包括酰化和总胃饥饿素水平。进食后酰化和总胃饥饿素浓度受到类似抑制，且在任何时间间隔我们均未发现各组之间存在任何显著差异。与基线值相比，吡格列酮治疗组观察到餐后酰化胃饥饿素浓度的抑制时间延长。总之，在仅接受二甲双胍、吡格列酮或饮食疗法治疗的2型糖尿病患者中，混合餐试验后的总胃饥饿素和酰化胃饥饿素水平相似。这些结果表明，二甲双胍和吡格列酮治疗期间体重的变化与血浆胃饥饿素水平无关。
