Department of Biochemistry, University of Toronto, Toronto, ON, Canada.
Diabetologia. 2010 Mar;53(3):552-61. doi: 10.1007/s00125-009-1611-5. Epub 2009 Dec 3.
AIMS/HYPOTHESIS: Glucagon-like peptide 1 (GLP-1) receptor (GLP-1R) agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors attenuate postprandial lipaemia through mechanisms that remain unclear. As dyslipidaemia is a contributing risk factor for cardiovascular disease in type 2 diabetes, we examined the mechanisms linking pharmacological and physiological regulation of GLP-1 action to control of postprandial lipid metabolism.
Postprandial lipid synthesis and secretion were assessed in normal and fructose-fed hamsters and in wild-type mice that were treated with or without sitagliptin. Apolipoprotein B-48 (ApoB-48) synthesis and secretion were also examined in primary enterocyte cultures. The importance of exogenous vs endogenous GLP-1R signalling for regulation of intestinal lipoprotein synthesis and secretion was assessed in mice and hamsters treated with the GLP-1R agonist exendin-4, the GLP-1R antagonist exendin(9-39) and in Glp1r (+/+) vs Glp1r (-/-) mice.
Sitagliptin decreased fasting plasma triacylglycerol, predominantly in the VLDL fraction, as well as postprandial triacylglycerol-rich lipoprotein (TRL)-triacylglycerol, TRL-cholesterol and TRL-ApoB-48 in hamsters and mice. GLP-1R activation with exendin-4 alone also decreased plasma and TRL-ApoB-48 in hamsters and mice, and reduced secretion of ApoB-48 in hamster enterocyte cultures. Conversely, blockade of endogenous GLP-1R signalling by the antagonist exendin(9-39) or genetic elimination of GLP-1R signalling in Glp1r (-/-) mice enhanced TRL-ApoB-48 secretion in vivo. Co-administration of exendin(9-39) also abolished the hypolipidaemic effect of sitagliptin.
CONCLUSIONS/INTERPRETATION: Potentiation of endogenous incretin action via DPP-4 inhibition or pharmacological augmentation of GLP-1R signalling reduces intestinal secretion of triacylglycerol, cholesterol and ApoB-48. Moreover, endogenous GLP-1R signalling is essential for the control of intestinal lipoprotein biosynthesis and secretion.
目的/假设:胰高血糖素样肽 1(GLP-1)受体(GLP-1R)激动剂和二肽基肽酶-4(DPP-4)抑制剂通过尚不清楚的机制减轻餐后血脂异常。由于血脂异常是 2 型糖尿病心血管疾病的一个致病危险因素,我们研究了将 GLP-1 作用的药理学和生理学调节与控制餐后脂质代谢联系起来的机制。
在正常和果糖喂养的仓鼠以及接受或不接受西他列汀治疗的野生型小鼠中评估了餐后脂质合成和分泌。还在原代肠细胞培养物中检查了载脂蛋白 B-48(ApoB-48)的合成和分泌。通过给予 GLP-1R 激动剂 exendin-4、GLP-1R 拮抗剂 exendin(9-39)以及在 Glp1r(+/+)与 Glp1r(-/-)小鼠中,评估了外源性与内源性 GLP-1R 信号对肠道脂蛋白合成和分泌的调节作用。
西他列汀降低了仓鼠和小鼠的空腹血浆三酰甘油,主要是在 VLDL 部分,以及餐后富含三酰甘油的脂蛋白(TRL)-三酰甘油、TRL-胆固醇和 TRL-ApoB-48。单独使用 exendin-4 激活 GLP-1R 也降低了仓鼠和小鼠的血浆和 TRL-ApoB-48,并减少了仓鼠肠细胞培养物中 ApoB-48 的分泌。相反,用拮抗剂 exendin(9-39)阻断内源性 GLP-1R 信号或在 Glp1r(-/-)小鼠中消除 GLP-1R 信号增强了体内 TRL-ApoB-48 的分泌。联合给予 exendin(9-39)也消除了西他列汀的降血脂作用。
结论/解释:通过 DPP-4 抑制增强内源性肠降血糖素作用或药理学增强 GLP-1R 信号可减少三酰甘油、胆固醇和 ApoB-48 的肠道分泌。此外,内源性 GLP-1R 信号对于控制肠道脂蛋白生物合成和分泌是必不可少的。