Xu Bilin, Shen Tian, Chen Lin, Xia Juan, Zhang Cuiping, Wang Hongping, Yu Ming, Lei Tao
Department of Endocrinology, Puto Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China (mainland).
Med Sci Monit. 2017 Mar 19;23:1363-1370. doi: 10.12659/msm.900033.
BACKGROUND In clinics, patients with type 2 diabetes complicated with non-alcoholic fatty liver disease (NAFLD) have been shown to receive significant improvements in blood glucose levels, lipid levels, and liver function after sitagliptin treatment, although the mechanism of drug action remains poorly understood. This study investigated the possible mechanism of sitagliptin on lipid metabolism of NAFLD mice. MATERIAL AND METHODS Male C57/BL6 mice were induced for NAFLD via 16 weeks of a high-fat diet, and were treated with 15 mg/kg/day sitagliptin for 16 consecutive weeks. Blood lipid levels were measured and samples were stained with hematoxylin and eosin (H&E) and oil red staining for liver pathology and lipid deposition. Serum levels of fibroblast growth factor (FGF)-9 and FGF-21 were quantified by enzyme-linked immunosorbent assay (ELISA). Peroxisome proliferator-activated receptor (PPAR)-α, and cAMP reactive element binding homolog (CREBH) were measured by Western blotting, while fatty acid synthase and carnitine palmitoyltransferase 1 (CPT1) mRNA levels were assayed by RT-PCR. RESULTS Compared to the control group, the NAFLD model mice had liver fatty disease, lower serum FGF-21 and FGF-19 levels, elevated serum lipid levels, depressed PPAR-α, CREBH, and CPT1 expression, and enhanced FAS expression (p<0.05). Sitagliptin treatment depressed blood lipid levels, increased serum FGF-21 and FGF-19 levels, PPAR-α, CREBH, and CPT1 expression, and suppressed FAS expression (p<0.05). CONCLUSIONS Sitagliptin can protect liver tissue and modulate lipid metabolism in NAFLD mice via elevating FGF-21 and FGF-19, upregulating liver PPAR-a and CREBH levels, and mediating expression levels of key enzymes for lipid metabolism.
背景 在临床上,已证实2型糖尿病合并非酒精性脂肪性肝病(NAFLD)的患者在接受西他列汀治疗后,血糖水平、血脂水平和肝功能有显著改善,尽管药物作用机制仍不清楚。本研究探讨西他列汀对NAFLD小鼠脂质代谢的可能机制。
材料与方法 雄性C57/BL6小鼠通过16周高脂饮食诱导为NAFLD,并连续16周每天用15mg/kg西他列汀治疗。测量血脂水平,样本用苏木精和伊红(H&E)染色以及油红染色以观察肝脏病理和脂质沉积。通过酶联免疫吸附测定(ELISA)定量血清成纤维细胞生长因子(FGF)-9和FGF-21水平。通过蛋白质印迹法测量过氧化物酶体增殖物激活受体(PPAR)-α和cAMP反应元件结合同源物(CREBH),同时通过逆转录-聚合酶链反应(RT-PCR)检测脂肪酸合酶和肉碱棕榈酰转移酶1(CPT1)mRNA水平。
结果 与对照组相比,NAFLD模型小鼠存在肝脏脂肪病变,血清FGF-21和FGF-19水平较低,血脂水平升高,PPAR-α、CREBH和CPT1表达降低,FAS表达增强(p<0.05)。西他列汀治疗可降低血脂水平,增加血清FGF-2-1和FGF-19水平、PPAR-α、CREBH和CPT1表达,并抑制FAS表达(p<0.05)。
结论 西他列汀可通过升高FGF-21和FGF-19、上调肝脏PPAR-α和CREBH水平以及调节脂质代谢关键酶的表达水平,保护NAFLD小鼠的肝组织并调节脂质代谢。