Davidson M B, Sladen G
Department of Medicine, Cedars-Sinai Medical Center-UCLA 90048.
Metabolism. 1987 Oct;36(10):925-30. doi: 10.1016/0026-0495(87)90125-9.
Sulfonylurea agents decrease hepatic glucose production and fasting glucose levels in type II diabetic patients without changing fasting insulin concentrations. This raises the possibility that these drugs may act directly on hepatic carbohydrate metabolism. Cultured rat hepatocytes were used to test this hypothesis. To ascertain whether this in vitro system was suitable to demonstrate an effect of sulfonylurea agents (eg, the well-documented insulin-potentiating action), we initially measured the effect of glyburide (2 micrograms/mL) on insulin-stimulated net glucose-14C incorporation into glycogen. Glyburide increased sensitivity to insulin (ie, shifted the dose-response curve to the left) without affecting either responsiveness or insulin binding. Thus, the ED50 was significantly lowered (8.4 v 15.2 ng/mL), whereas the percent increase (181% v 170%) over the basal level, specific tracer insulin binding (5.3% v 5.1% per mg protein), and the Scatchard plots were similar. Since an effect of sulfonylurea agents could be demonstrated in this system, and the glycogen pathways supply 75% of hepatic glucose production after an overnight fast, we next measured the direct effect of glyburide (2 micrograms/mL) on glycogen storage and breakdown. Glycogenolysis was assessed by measuring the breakdown of prelabeled glycogen (from galactose-14C) and glycogen synthesis by the incorporation of glucose-C14 into glycogen. Glyburide significantly inhibited glycogenolysis and stimulated glycogen synthesis. Furthermore, glyburide significantly stimulated glycogen synthase while glycogen phosphorylase was unaffected. In conclusion, glyburide directly inhibited glycogenolysis, stimulated glycogen synthesis and glycogen synthase, and potentiated the action of insulin on glycogen synthesis at a postbinding site in cultured rat hepatocytes.(ABSTRACT TRUNCATED AT 250 WORDS)
磺脲类药物可降低II型糖尿病患者的肝葡萄糖生成及空腹血糖水平,而不改变空腹胰岛素浓度。这增加了这些药物可能直接作用于肝脏碳水化合物代谢的可能性。使用培养的大鼠肝细胞来检验这一假设。为确定该体外系统是否适合证明磺脲类药物的作用(例如,已充分证明的胰岛素增强作用),我们首先测定了格列本脲(2微克/毫升)对胰岛素刺激的14C葡萄糖掺入糖原的净效应。格列本脲增加了对胰岛素的敏感性(即剂量反应曲线左移),而不影响反应性或胰岛素结合。因此,半数有效剂量(ED50)显著降低(8.4对15.2纳克/毫升),而相对于基础水平的增加百分比(181%对170%)、特异性示踪胰岛素结合(每毫克蛋白质5.3%对5.1%)以及Scatchard图相似。由于在该系统中可证明磺脲类药物的作用,且过夜禁食后糖原途径提供75%的肝葡萄糖生成,接下来我们测定了格列本脲(2微克/毫升)对糖原储存和分解的直接作用。通过测量预先标记的糖原(来自半乳糖-14C)的分解来评估糖原分解,并通过将14C葡萄糖掺入糖原中来评估糖原合成。格列本脲显著抑制糖原分解并刺激糖原合成。此外,格列本脲显著刺激糖原合酶,而糖原磷酸化酶未受影响。总之,在培养的大鼠肝细胞中,格列本脲直接抑制糖原分解,刺激糖原合成及糖原合酶,并在结合后位点增强胰岛素对糖原合成的作用。(摘要截短于250字)