Grunstein H S, Smythe G A, Bradshaw J E, Compton P J
Diabetes. 1986 Apr;35(4):475-80. doi: 10.2337/diab.35.4.475.
Sulfonylureas are potent hypoglycemic agents; however, their mechanism of action remains incompletely understood. Recent data indicate that hypothalamic norepinephrine (NE) plays a major role in mediating the central neural regulation of blood glucose. We therefore examined whether the sulfonylurea tolbutamide might lower serum glucose via an effect on hypothalamic NE neuronal activity, and compared the effects with those of 2-deoxyglucose-induced neuroglycopenia and of chronic insulin administration. Serum glucose levels fell and serum insulin levels rose 10, 20, and 30 min after acute tolbutamide injection. Serum glucose concentrations were reduced after chronic tolbutamide administered in drinking water, but serum insulin did not change. Hypothalamic NE neuronal activity was increased 10 min after tolbutamide administration, but not at the later times, nor during chronic tolbutamide administration. However, consistent with a rise in serotonin (5-HT) neuronal activity, hypothalamic 5-hydroxyindoleacetic acid (5-HIAA) and the 5-HIAA/5-HT ratio rose 30 min after acute tolbutamide and during chronic tolbutamide administration. This rise was not due to neuroglycopenia per se, since hypothalamic NE neuronal activity was increased and hypothalamic 5-HT neuronal activity was reduced after 2-deoxyglucose-induced neuroglycopenia. Furthermore, the effect of chronic tolbutamide contrasted with that of chronic insulin administration where hypothalamic NE neuronal activity was increased, while hypothalamic 5-HT neuronal activity was unchanged. We conclude that tolbutamide does not lower serum glucose via a direct effect on hypothalamic NE neuronal activity; however, we note that tolbutamide specifically increases hypothalamic 5-HT neuronal activity.(ABSTRACT TRUNCATED AT 250 WORDS)
磺脲类药物是强效降糖药;然而,其作用机制仍未完全明确。近期数据表明,下丘脑去甲肾上腺素(NE)在介导血糖的中枢神经调节中起主要作用。因此,我们研究了磺脲类药物甲苯磺丁脲是否可能通过影响下丘脑NE神经元活动来降低血糖,并将其效果与2-脱氧葡萄糖诱导的低血糖症以及长期注射胰岛素的效果进行比较。急性注射甲苯磺丁脲后10、20和30分钟,血清葡萄糖水平下降,血清胰岛素水平上升。饮用含甲苯磺丁脲的水进行长期给药后,血清葡萄糖浓度降低,但血清胰岛素没有变化。甲苯磺丁脲给药后10分钟,下丘脑NE神经元活动增加,但在随后的时间以及长期给药期间并未增加。然而,与血清素(5-HT)神经元活动增加一致,急性注射甲苯磺丁脲后30分钟以及长期给药期间,下丘脑5-羟吲哚乙酸(5-HIAA)和5-HIAA/5-HT比值升高。这种升高并非本身由低血糖症所致,因为2-脱氧葡萄糖诱导的低血糖症后,下丘脑NE神经元活动增加而下丘脑5-HT神经元活动减少。此外,长期甲苯磺丁脲的作用与长期注射胰岛素的作用形成对比,长期注射胰岛素时下丘脑NE神经元活动增加,而下丘脑5-HT神经元活动无变化。我们得出结论,甲苯磺丁脲并非通过直接影响下丘脑NE神经元活动来降低血糖;然而,我们注意到甲苯磺丁脲特异性增加下丘脑5-HT神经元活动。(摘要截短至250字)