内源性释放的葡萄糖、胰岛素、胰高血糖素样肽1、胃饥饿素对心输出量、心率、每搏输出量和血压的影响。
The effect of endogenously released glucose, insulin, glucagon-like peptide 1, ghrelin on cardiac output, heart rate, stroke volume, and blood pressure.
作者信息
Hlebowicz Joanna, Lindstedt Sandra, Björgell Ola, Dencker Magnus
机构信息
Center for Emergency, Department of Cardiology, Skåne University Hospital, Malmö, Lund University, Sweden.
出版信息
Cardiovasc Ultrasound. 2011 Dec 29;9:43. doi: 10.1186/1476-7120-9-43.
BACKGROUND
Ingestion of a meal increases the blood flow to the gastrointestinal organs and affects the heart rate (HR), blood pressure and cardiac output (CO), although the mechanisms are not known. The aim of this study was to evaluate the effect of endogenously released glucose, insulin, glucagon-like peptide 1 (GLP-1), ghrelin on CO, HR, stroke volume (SV), and blood pressure.
METHODS
Eleven healthy men and twelve healthy women ((mean ± SEM) aged: 26 ± 0.2 y; body mass index: 21.8 ± 0.1 kg/m(2))) were included in this study. The CO, HR, SV, systolic and diastolic blood pressure, antral area, gastric emptying rate, and glucose, insulin, GLP-1 and ghrelin levels were measured.
RESULTS
The CO and SV at 30 min were significantly higher, and the diastolic blood pressure was significantly lower, than the fasting in both men and women (P < 0.05). In men, significant correlations were found between GLP-1 level at 30 min and SV at 30 min (P = 0.015, r = 0.946), and between ghrelin levels and HR (P = 0.013, r = 0.951) at 110 min. Significant correlations were also found between the change in glucose level at 30 min and the change in systolic blood pressure (P = 0.021, r = -0.681), and the change in SV (P = 0.008, r = -0.748) relative to the fasting in men. The insulin 0-30 min AUC was significantly correlated to the CO 0-30 min AUC (P = 0.002, r = 0.814) in men. Significant correlations were also found between the 0-120 min ghrelin and HR AUCs (P = 0.007, r = 0.966) in men. No statistically significant correlations were seen in women.
CONCLUSIONS
Physiological changes in the levels of glucose, insulin, GLP-1 and ghrelin may influence the activity of the heart and the blood pressure. There may also be gender-related differences in the haemodynamic responses to postprandial changes in hormone levels. The results of this study show that subjects should not eat immediately prior to, or during, the evaluation of cardiovascular interventions as postprandial affects may affect the results, leading to erroneous interpretation of the cardiovascular effects of the primary intervention.
TRIAL REGISTRATION NUMBER
NCT01027507.
背景
进食会增加胃肠道器官的血流量，并影响心率（HR）、血压和心输出量（CO），但其机制尚不清楚。本研究的目的是评估内源性释放的葡萄糖、胰岛素、胰高血糖素样肽1（GLP-1）、胃饥饿素对心输出量、心率、每搏输出量（SV）和血压的影响。
方法
本研究纳入了11名健康男性和12名健康女性（（平均±标准误）年龄：26±0.2岁；体重指数：21.8±0.1kg/m²）。测量了心输出量、心率、每搏输出量、收缩压和舒张压、胃窦面积、胃排空率以及葡萄糖、胰岛素、GLP-1和胃饥饿素水平。
结果
30分钟时，男性和女性的心输出量和每搏输出量均显著高于空腹水平，舒张压显著低于空腹水平（P<0.05）。在男性中，30分钟时的GLP-1水平与30分钟时的每搏输出量之间存在显著相关性（P=0.015，r=0.946），110分钟时胃饥饿素水平与心率之间存在显著相关性（P=0.013，r=0.951）。相对于空腹状态，男性30分钟时血糖水平的变化与收缩压的变化之间（P=0.021，r=-0.681）以及与每搏输出量的变化之间（P=0.008，r=-0.748）也存在显著相关性。男性胰岛素0-30分钟的曲线下面积（AUC）与心输出量0-30分钟的AUC显著相关（P=0.002，r=0.814）。男性0-120分钟胃饥饿素与心率的AUC之间也存在显著相关性（P=0.007，r=0.966）。女性未发现统计学上的显著相关性。
结论
葡萄糖、胰岛素、GLP-1和胃饥饿素水平的生理变化可能会影响心脏活动和血压。激素水平餐后变化的血流动力学反应可能也存在性别差异。本研究结果表明，在评估心血管干预措施之前或期间，受试者不应立即进食，因为餐后影响可能会影响结果，导致对主要干预措施的心血管效应产生错误解读。
试验注册号
NCT01027507。
Zotero 插件