在禁食或对 SGLT2 抑制的反应中,胰高血糖素在酮体生成中的作用有限。
The Limited Role of Glucagon for Ketogenesis During Fasting or in Response to SGLT2 Inhibition.
机构信息
Duke Molecular Physiology Institute, Duke University, Durham, NC.
Division of Endocrinology, Department of Medicine, Duke University, Durham, NC.
出版信息
Diabetes. 2020 May;69(5):882-892. doi: 10.2337/db19-1216. Epub 2020 Jan 31.
Glucagon is classically described as a counterregulatory hormone that plays an essential role in the protection against hypoglycemia. In addition to its role in the regulation of glucose metabolism, glucagon has been described to promote ketosis in the fasted state. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a new class of glucose-lowering drugs that act primarily in the kidney, but some reports have described direct effects of SGLT2i on α-cells to stimulate glucagon secretion. Interestingly, SGLT2 inhibition also results in increased endogenous glucose production and ketone production, features common to glucagon action. Here, we directly test the ketogenic role of glucagon in mice, demonstrating that neither fasting- nor SGLT2i-induced ketosis is altered by interruption of glucagon signaling. Moreover, any effect of glucagon to stimulate ketogenesis is severely limited by its insulinotropic actions. Collectively, our data suggest that fasting-associated ketosis and the ketogenic effects of SGLT2 inhibitors occur almost entirely independent of glucagon.
胰高血糖素通常被描述为一种对抗激素,在防止低血糖中起着至关重要的作用。除了在调节葡萄糖代谢中的作用外,胰高血糖素还被描述为在禁食状态下促进酮体生成。钠-葡萄糖共转运蛋白 2 抑制剂(SGLT2i)是一类新型的降血糖药物,主要在肾脏中起作用,但有一些报道描述了 SGLT2i 对α细胞的直接作用,刺激胰高血糖素分泌。有趣的是,SGLT2 抑制也会导致内源性葡萄糖产生和酮体产生增加,这是胰高血糖素作用的共同特征。在这里,我们直接在小鼠中测试了胰高血糖素的生酮作用,结果表明,禁食或 SGLT2i 诱导的酮症均不受胰高血糖素信号中断的影响。此外,胰高血糖素刺激酮体生成的任何作用都受到其胰岛素促分泌作用的严重限制。总之,我们的数据表明,与禁食相关的酮症以及 SGLT2 抑制剂的生酮作用几乎完全独立于胰高血糖素。