Rogers B J, Standaert M L, Pollet R J
Department of Medicine, University of South Florida, Tampa.
Diabetes. 1987 Nov;36(11):1292-6. doi: 10.2337/diab.36.11.1292.
The actions of sulfonylurea agents to increase peripheral glucose disposal have been classically ascribed to an ability to potentiate insulin action. However, in the BC3H-1 cultured muscle cell, tolbutamide, glipizide, and glyburide directly provoked more than a twofold increase in 2-deoxyglucose (2-DG) uptake in a dose-dependent manner in the absence of insulin. Tolbutamide (3 mM) enhanced 2-DG uptake by 130% in the presence or absence of insulin and did not significantly change insulin binding or the sensitivity of the insulin response. The onset of tolbutamide-stimulated hexose transport was seen after 30 min and reached a plateau after 12 h. Tolbutamide-stimulated glucose transport was associated with a twofold increase in the Vmax of 2-DG uptake and was completely blocked by 50 microM cytochalasin B, indicating that this action is mediated by increase in cell membrane glucose transporters. We show that sulfonylureas at therapeutic concentrations directly increase glucose transport into muscle cells. Because muscle is the major peripheral target tissue for glucose disposal, these results provide the basis for the therapeutic effect of these agents in improving peripheral glucose disposal in insulin-resistant type II (non-insulin-dependent) diabetes mellitus.
磺酰脲类药物增加外周葡萄糖代谢的作用传统上归因于其增强胰岛素作用的能力。然而,在BC3H-1培养的肌肉细胞中,甲苯磺丁脲、格列吡嗪和格列本脲在无胰岛素的情况下,以剂量依赖的方式直接使2-脱氧葡萄糖(2-DG)摄取增加了两倍多。在有或无胰岛素的情况下,3 mM甲苯磺丁脲使2-DG摄取增加了130%,且未显著改变胰岛素结合或胰岛素反应的敏感性。甲苯磺丁脲刺激的己糖转运在30分钟后开始,12小时后达到平台期。甲苯磺丁脲刺激的葡萄糖转运与2-DG摄取的Vmax增加两倍相关,并被50 μM细胞松弛素B完全阻断,表明该作用是由细胞膜葡萄糖转运体增加介导的。我们表明,治疗浓度的磺酰脲类药物可直接增加葡萄糖转运进入肌肉细胞。由于肌肉是外周葡萄糖代谢的主要靶组织,这些结果为这些药物改善胰岛素抵抗的II型(非胰岛素依赖型)糖尿病外周葡萄糖代谢的治疗效果提供了依据。