依西那肽纠正伴有葡萄糖耐量受损的年轻囊性纤维化患者的餐后高血糖:一项随机交叉试验。
Exenatide corrects postprandial hyperglycaemia in young people with cystic fibrosis and impaired glucose tolerance: A randomized crossover trial.
机构信息
Department of Endocrinology and Diabetes, Women's and Children's Hospital, Adelaide, South Australia, Australia.
Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
出版信息
Diabetes Obes Metab. 2019 Mar;21(3):700-704. doi: 10.1111/dom.13544. Epub 2018 Oct 25.
Impaired glucose tolerance (IGT) in cystic fibrosis (CF) manifests as postprandial hyperglycaemia. Pancreatic enzyme supplementation reduces the latter; restoring incretin secretion and slowing gastric emptying. We aimed to determine the acute effect of exenatide on postprandial glycaemia in young people with CF and IGT. Six participants with CF and IGT were studied on 2 days, in a double-blind randomized crossover trial. After overnight fasting, they received exenatide 2.5 mcg or placebo (0.9% saline) subcutaneously 15 minutes before a pancake meal labelled with C octanoate and pancreatic enzyme replacement. The primary outcomes, area under the curve over 240 minutes (AUC ) for blood glucose (P < 0.0001) and peak blood glucose (7.65 mM ± 0.34 [mean ± SE] vs 9.53 mM ± 0.63, P < 0.0001), were markedly lower after exenatide than placebo. AUC for insulin, C-peptide, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) was also lower after exenatide. Gastric emptying was markedly slower after exenatide, as assessed by time for 10% gastric emptying and peak CO excretion. We report for the first time that exenatide corrects postprandial hyperglycaemia in young people with CF and IGT. GLP-1 agonists are a candidate treatment in CF-related diabetes.
在囊性纤维化 (CF) 中,葡萄糖耐量受损 (IGT) 表现为餐后高血糖。胰酶补充可降低后者;恢复肠促胰岛素分泌并减缓胃排空。我们旨在确定 exenatide 对 IGT 年轻 CF 患者餐后血糖的急性影响。
在一项双盲随机交叉试验中,六名患有 CF 和 IGT 的参与者在两天内进行了研究。禁食过夜后,他们在食用标有 C 辛酸和胰酶替代物的薄煎饼餐之前 15 分钟接受 exenatide 2.5 mcg 或安慰剂(0.9%生理盐水)皮下注射。主要结局,240 分钟时血糖的曲线下面积 (AUC)(P < 0.0001)和峰值血糖(7.65 mM ± 0.34 [均值 ± SE] 与 9.53 mM ± 0.63,P < 0.0001),在 exenatide 后明显低于安慰剂。AUC 胰岛素、C 肽、胰高血糖素样肽-1 (GLP-1) 和葡萄糖依赖性胰岛素释放肽 (GIP) 也在 exenatide 后降低。通过 10%胃排空和 CO 峰值排泄的时间评估,胃排空明显更慢。
我们首次报道,exenatide 可纠正 IGT 年轻 CF 患者的餐后高血糖。GLP-1 激动剂是 CF 相关糖尿病的候选治疗药物。