Paterson K R, Gyi K M, McBride D, Cohen H N, Shenkin A, Manderson W G, MacCuish A C
Diabet Med. 1985 Jan;2(1):38-40. doi: 10.1111/j.1464-5491.1985.tb00590.x.
Sulphonylureas lower blood glucose but other metabolic effects have been little studied. In an assessment of carbohydrate and amino acid metabolism in 9 patients with non-insulin-dependent diabetes mellitus (NIDDM) before and after 3 months' therapy with gliclazide, glycaemic control was improved (mean +/- S.D. glycosylated haemoglobin 13.8 +/- 1.9% before therapy, 10.2 +/- 2.1% after therapy (p less than 0.01], but fasting amino acid levels were not altered. In contrast, postprandial levels of branched chain amino acids (BCAA) were significantly reduced: total BCAA (valine, leucine, and isoleucine) 120 mins following a standard test meal fell from 717 +/- 71 mumol/l before therapy to 600 +/- 90 mumol/l after 3 months' therapy (p less than 0.01). This finding implies an increased action of endogenous insulin on skeletal muscle to promote uptake of BCAA postprandially and, in accord with this, peripheral insulin levels were significantly increased following drug treatment (peak insulin level 55.6 +/- 20.2 mU/l before therapy, 91.3 +/- 17.9 mU/l after therapy (p less than 0.01]. Sulphonylurea drugs therefore do not simply have a hypoglycaemic action but also affect amino acid metabolism in NIDDM patients.
磺脲类药物可降低血糖，但对其他代谢作用的研究较少。在一项对9例非胰岛素依赖型糖尿病（NIDDM）患者进行的研究中，评估了其在接受格列齐特治疗3个月前后的碳水化合物和氨基酸代谢情况。结果显示，血糖控制得到改善（治疗前糖化血红蛋白平均±标准差为13.8±1.9%，治疗后为10.2±2.1%（p<0.01）），但空腹氨基酸水平未发生改变。相比之下，餐后支链氨基酸（BCAA）水平显著降低：标准试验餐后120分钟，总BCAA（缬氨酸、亮氨酸和异亮氨酸）水平从治疗前的717±71μmol/L降至3个月治疗后的600±90μmol/L（p<0.01）。这一发现表明内源性胰岛素对骨骼肌的作用增强，从而促进餐后BCAA的摄取，与此一致的是，药物治疗后外周胰岛素水平显著升高（治疗前胰岛素峰值水平为55.6±20.2mU/L，治疗后为91.3±17.9mU/L（p<0.01））。因此，磺脲类药物不仅具有降血糖作用，还会影响NIDDM患者的氨基酸代谢。
