Schaller G, Kretschmer S, Gouya G, Haider D G, Mittermayer F, Riedl M, Wagner O, Pacini G, Wolzt M, Ludvik B
Department of Clinical Pharmacology, Medical University of Vienna, Austria.
Exp Clin Endocrinol Diabetes. 2010 Jan;118(1):57-60. doi: 10.1055/s-0029-1233453. Epub 2009 Oct 15.
Moderate alcohol consumption is associated with increased insulin sensitivity and reduced cardiovascular risk. We hypothesized that this relates to a direct effect of alcohol and therefore investigated whether acute alcohol intake altered insulin sensitivity or endothelial function in patients with type 2 diabetes. In an open-label two period design, the effect of a single oral dose of 40 g of alcohol (168 ml 40% vodka) on an insulin-modified frequently sampled intravenous glucose tolerance test (FSIGT) and on endothelium-dependent (flow mediated, FMD) or endothelium-independent (glyceroltrinitrate (GTN)-induced) vasodilation of the brachial artery measured by ultrasound was studied. Experiments were carried out in twelve male patients with type 2 diabetes mellitus (64+/-6 years, body mass index 28.4+/-5.7 kg/m (2)). Baseline insulin sensitivity index (S (I)) was 1.10+/-0.34 min (-1).microU (-1).ml, baseline FMD was +4.1+/-3.0%, and GTN-induced vasodilation +7.4+/-2.3% from resting brachial artery diameter. Acute alcohol intake increased alcohol plasma levels to 0.33+/-0.04 per thousand, S (I) to 1.86+/-0.45 min (-1).microU (-1).ml (p<0.05), and FMD to +8.2+/-2.8% (p<0.05), while GTN-induced dilation remained unchanged. No relationship was detectable between the observed changes. We conclude that alcohol intake acutely increases endothelium-dependent brachial artery vasodilation in patients with type 2 diabetes together with insulin sensitivity. This acute effect might explain some beneficial effects of low alcohol consumption in epidemiological observations.
适度饮酒与胰岛素敏感性增加和心血管风险降低有关。我们推测这与酒精的直接作用有关，因此研究了急性饮酒是否会改变2型糖尿病患者的胰岛素敏感性或内皮功能。在一项开放标签的两阶段设计中，研究了单次口服40克酒精（168毫升40%伏特加）对胰岛素改良的频繁采样静脉葡萄糖耐量试验（FSIGT）以及通过超声测量的肱动脉内皮依赖性（血流介导的，FMD）或内皮非依赖性（硝酸甘油（GTN）诱导的）血管舒张的影响。实验在12名2型糖尿病男性患者中进行（64±6岁，体重指数28.4±5.7千克/米²）。基线胰岛素敏感性指数（S（I））为1.10±0.34分钟⁻¹·微单位⁻¹·毫升，基线FMD为+4.1±3.0%，GTN诱导的血管舒张相对于静息肱动脉直径为+7.4±2.3%。急性饮酒使血浆酒精水平升至0.33±0.04‰，S（I）升至1.86±0.45分钟⁻¹·微单位⁻¹·毫升（p<0.05），FMD升至+8.2±2.8%（p<0.05），而GTN诱导的舒张保持不变。未观察到所观察到的变化之间存在相关性。我们得出结论，饮酒会使2型糖尿病患者的内皮依赖性肱动脉血管舒张以及胰岛素敏感性急性增加。这种急性效应可能解释了流行病学观察中低酒精摄入量的一些有益作用。
