Takahashi Tetsuya, Kawano Takashi, Eguchi Satoru, Chi Haidong, Iwata Hideki, Yokoyama Masataka
Department of Anesthesiology and Intensive Care Medicine, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan.
Department of Dental Anesthesiology, Tokushima University School of Dentistry, Tokushima, Japan.
J Anesth. 2015 Jun;29(3):396-402. doi: 10.1007/s00540-014-1943-2. Epub 2014 Nov 7.
Dexmedetomidine acts as a selective α2-adrenergic receptor agonist and an imidazoline receptor agonist, both of which are known to affect insulin secretion. Here, we investigated the effects of clinically relevant concentrations of dexmedetomidine on insulin secretion under in vivo conditions. Furthermore, its underlying mechanisms were examined using isolated islets in vitro.
For the in vivo oral glucose tolerance test (OGTT), male Sprague-Dawley rats were randomly allocated to one of three groups (n = 7 in each group): two groups infused with dexmedetomidine at a low (group L) or a high (group H) dose, and one control group infused with the same amount of saline (group C). For the in vitro perifusion study, insulin released from isolated islets was measured during stepwise changes in glucose. Dexmedetomidine (0.1-100 µM) was added to the chamber.
During the OGTT test, the insulin levels in group H were significantly lower than those in group C at 30, 60, and 90 min after glucose load. On the other hand, insulin levels in group L were comparable to those of group C at all time points. In the perfusion study, dexmedetomidine inhibited glucose-stimulated insulin secretion in a concentration-dependent manner. When co-treated with yohimbine, an α2-adrenoceptor blocker, dexmedetomidine adversely increased glucose-induced insulin secretion. However, co-treatment with idazoxan, an antagonist for α2-adrenergic and imidazoline receptors, completely abolished the action of dexmedetomidine.
Dexmedetomidine had no effect on insulin secretion at sedative dose, whereas it significantly inhibited insulin secretion at supraclinical high concentrations mainly via the α2-adrenoceptor.
右美托咪定作为一种选择性α2肾上腺素能受体激动剂和一种咪唑啉受体激动剂,已知二者均会影响胰岛素分泌。在此,我们研究了临床相关浓度的右美托咪定在体内条件下对胰岛素分泌的影响。此外,使用体外分离的胰岛研究了其潜在机制。
对于体内口服葡萄糖耐量试验(OGTT),将雄性Sprague-Dawley大鼠随机分为三组之一(每组n = 7):两组分别以低剂量(L组)或高剂量(H组)输注右美托咪定,一组对照组输注等量生理盐水(C组)。对于体外灌注研究,在葡萄糖逐步变化过程中测量分离胰岛释放的胰岛素。向腔室中加入右美托咪定(0.1 - 100 μM)。
在OGTT试验期间,葡萄糖负荷后30、60和90分钟时,H组的胰岛素水平显著低于C组。另一方面,L组在所有时间点的胰岛素水平与C组相当。在灌注研究中,右美托咪定以浓度依赖的方式抑制葡萄糖刺激的胰岛素分泌。当与α2肾上腺素能受体阻滞剂育亨宾共同处理时,右美托咪定反而增加了葡萄糖诱导的胰岛素分泌。然而,与α2肾上腺素能和咪唑啉受体拮抗剂伊达唑胺共同处理时,完全消除了右美托咪定的作用。
右美托咪定在镇静剂量下对胰岛素分泌无影响,而在超临床高浓度时主要通过α2肾上腺素能受体显著抑制胰岛素分泌。