Lebovitz Harold E
a Department of Medicine, Division of Endocrinology, State University of New York Health Science Center at Brooklyn, NY, USA.
Expert Rev Endocrinol Metab. 2012 Nov;7(6):599-609. doi: 10.1586/eem.12.50.
Amylin is a naturally occurring hormone that regulates food intake and postprandial glucose excursions. Amylin is synthesized in the β cell and cosecreted with insulin. Type 1 diabetes and insulin-requiring Type 2 diabetes are amylin-deficient as well as insulin-deficient states. Pramlintide is a synthetic amylin analog that is used for replacement therapy. Pramlintide therapy slows diabetes-mediated accelerated gastric emptying and restores meal-mediated suppression of glucagon secretion in patients with diabetes. Amylin receptors are primarily located in the CNS, which mediates all of its effects including decreases in food intake. In patients with diabetes, pramlintide treatment reduces hemoglobin A1C (HbA1c) 0.3-0.7% and decreases bodyweight. Side effects include nausea and hypoglycemia. Both can be minimized by an appropriate titration program. Recent pramlintide studies address improvements in delivery systems, use in pediatric and Type 2 diabetic populations, patient treatment satisfaction and new insights into its mechanisms of action.
胰淀素是一种天然存在的激素，可调节食物摄入和餐后血糖波动。胰淀素在β细胞中合成，并与胰岛素共同分泌。1型糖尿病和需要胰岛素治疗的2型糖尿病患者存在胰淀素缺乏以及胰岛素缺乏的情况。普兰林肽是一种用于替代治疗的合成胰淀素类似物。普兰林肽治疗可减缓糖尿病介导的胃排空加速，并恢复糖尿病患者进餐介导的胰高血糖素分泌抑制作用。胰淀素受体主要位于中枢神经系统，中枢神经系统介导其所有作用，包括减少食物摄入。在糖尿病患者中，普兰林肽治疗可使糖化血红蛋白（HbA1c）降低0.3 - 0.7%，并减轻体重。副作用包括恶心和低血糖。通过适当的滴定方案，这两种副作用均可降至最低。最近关于普兰林肽的研究涉及给药系统的改进、在儿科和2型糖尿病患者群体中的应用、患者治疗满意度以及对其作用机制的新见解。
