外源性胰高血糖素样肽-1 对健康老年受试者血压、心率、肠系膜血流和经十二指肠葡萄糖后血糖反应的影响。

Effects of exogenous glucagon-like peptide-1 on the blood pressure, heart rate, mesenteric blood flow, and glycemic responses to intraduodenal glucose in healthy older subjects.

机构信息

Discipline of Medicine (L.G.T., M.H., C.F.-B., C.K.R., K.L.J.), The University of Adelaide, Adelaide 5005, Australia; National Health and Medical Research Council Centre of Research Excellence in Translating Nutritional Science to Good Health (L.G.T., M.H., C.F.-B., C.K.R., K.L.J.), The University of Adelaide, Adelaide 5005, Australia; and Section for Gastroenterology (T.H.), Department of Clinical Medicine, University of Bergen, N-5020 Bergen, Norway.

出版信息

J Clin Endocrinol Metab. 2014 Dec;99(12):E2628-34. doi: 10.1210/jc.2014-2475.

DOI:10.1210/jc.2014-2475

PMID:25210879

Abstract

CONTEXT

Studies relating to the cardiovascular effects of glucagon-like peptide-1 (GLP-1) and its agonists, which slow gastric emptying, have not discriminated between fasting and postprandial, blood pressure (BP) and heart rate (HR).

OBJECTIVE

To determine whether exogenous GLP-1 modulates the effects of an intraduodenal (ID) glucose infusion on BP, HR, and splanchnic blood flow in healthy older subjects.

DESIGN

A double-blind randomized trial was conducted.

SETTING

Community-dwelling residents attended a clinical research laboratory.

PATIENTS

Ten healthy "older" subjects (9 male, 1 female; age 73.2 ± 1.5 y) were studied.

INTERVENTIONS

Intravenous infusion of GLP-1 (0.9 pmol/kg/min), or saline (0.9%) for 90 min (t = -30-60 min). Between t = 0-60 min, ID glucose was infused at 3 kcal/min.

MAIN OUTCOME MEASURES

BP, HR, superior mesenteric artery (SMA) flow, blood glucose, and serum insulin were measured.

RESULTS

During the fasting period (t = -30-0 min), GLP-1 had no effect on BP or HR. In response to ID glucose (t = 0-60 min), systolic BP decreased (P < .001), and both HR (P < .001) and SMA flow (P < .05) increased, on both days. GLP-1 attenuated the maximum decrease in systolic BP (P < .05), tended to increase HR (P = .09), and increased SMA flow (P < .01). GLP-1 diminished the glycemic response (P < .05).

CONCLUSIONS

In healthy older subjects, acute administration of GLP-1 attenuates the hypotensive response to ID glucose, and potentiates the increase in SMA flow.

摘要

背景

研究表明，胰高血糖素样肽-1（GLP-1）及其类似物可减缓胃排空，从而对心血管系统产生影响，但这些研究并未区分空腹和餐后、血压（BP）和心率（HR）。

目的

确定外源性 GLP-1 是否调节健康老年受试者十二指肠内（ID）葡萄糖输注对血压、心率和内脏血流的影响。

设计

双盲随机试验。

地点

居住在社区的居民参加临床研究实验室。

患者

10 名健康“老年”受试者（9 名男性，1 名女性；年龄 73.2 ± 1.5 岁）接受了研究。

干预措施

静脉输注 GLP-1（0.9 pmol/kg/min）或生理盐水（0.9%）90 分钟（t = -30-60 分钟）。在 t = 0-60 分钟期间，以 3 kcal/min 的速度输注 ID 葡萄糖。

主要观察指标

血压、心率、肠系膜上动脉（SMA）流量、血糖和血清胰岛素。

结果

在禁食期（t = -30-0 分钟），GLP-1 对 BP 或 HR 没有影响。在 ID 葡萄糖反应期间（t = 0-60 分钟），收缩压降低（P <.001），心率（P <.001）和 SMA 流量（P <.05）均增加，两种情况下均如此。GLP-1 减弱了收缩压的最大降低（P <.05），倾向于增加心率（P =.09），并增加了 SMA 流量（P <.01）。GLP-1 降低了血糖反应（P <.05）。