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电针联合阿卡波糖通过过氧化物酶体增殖物激活受体 γ 激活改善胰岛素敏感性,并且在类固醇诱导的胰岛素抵抗大鼠模型中比单独使用阿卡波糖产生更强的降血糖作用。

Electroacupuncture combined with acarbose improves insulin sensitivity via peroxisome proliferator-activated receptor γ activation and produces a stronger glucose-lowering effect than acarbose alone in a rat model of steroid-induced insulin resistance.

机构信息

Department of Surgery, Cheng Ching Hospital, Taichung City.

Department of Medicinal Botanicals and Health Applications, Da-Yeh University, Dacun.

出版信息

Acupunct Med. 2020 Oct;38(5):335-342. doi: 10.1177/0964528419901135. Epub 2020 Apr 16.

Abstract

BACKGROUND

Previous studies have reported that electroacupuncture (EA) induces a glucose-lowering effect by improving insulin resistance (IR) and reduces plasma free fatty acid (FFA) levels in rats with steroid-induced insulin resistance (SIIR). In addition, EA can activate cholinergic nerves and stimulate endogenous opioid peptides to lower plasma glucose in streptozotocin-induced hyperglycemic rats. The aim of this study was to investigate the glucose-lowering effects of 15 Hz EA at bilateral ST36 in combination with acarbose (ACA). We hypothesized that EA combined with ACA would produce a stronger glucose-lowering effect than ACA alone.

METHODS

In this study, normal Wistar rats and SIIR rats were randomly divided into two groups: ACA and ACA + EA. To explore the potential mechanisms underlying the glucose-lowering effect, plasma FFA/insulin and insulin transduction signal pathway proteins were assayed.

RESULTS

Combined ACA + EA treatment had a greater glucose-lowering effect than ACA alone in normal Wistar rats (-45% ± 3% vs -19% ± 3%,  < 0.001) and SIIR model rats (-43% ± 2% vs -16% ± 6%,  < 0.001). A significant reduction in plasma FFA levels, improvement in homeostatic model assessment of IR (HOMA-IR) index (-48.9% ± 4.0%,  < 0.001) and insulin sensitivity index (102% ± 16.9%,  < 0.001), and significant increases in insulin receptor substrate 1, glucose transporter 4, and peroxisome proliferator-activated receptor γ protein expressions in skeletal muscle, were also observed in the ACA + EA group of SIIR rats.

CONCLUSION

Combined EA and ACA therapy had a greater glucose-lowering effect than ACA monotherapy; this combined therapy could be more effective at improving IR in SIIR rats, which may be related to a reduction in plasma FFA levels and an elevation of insulin signaling proteins. Whether this combined therapy has an effect in type 2 diabetes mellitus (T2DM) patients still needs to be explored.

摘要

背景

既往研究报道电针(EA)通过改善胰岛素抵抗(IR)降低固醇诱导的胰岛素抵抗(SIIR)大鼠的血浆游离脂肪酸(FFA)水平,从而产生降糖作用。此外,电针可激活胆碱能神经并刺激内源性阿片肽,降低链脲佐菌素诱导的高血糖大鼠的血糖。本研究旨在探讨双侧足三里穴 15Hz 电针对阿卡波糖(ACA)的降糖作用。我们假设电针与 ACA 联合应用比单独应用 ACA 降糖作用更强。

方法

本研究将正常 Wistar 大鼠和 SIIR 大鼠随机分为 ACA 和 ACA+EA 两组。为探讨降糖作用的潜在机制,检测了血浆 FFA/胰岛素和胰岛素转导信号通路蛋白。

结果

与 ACA 单药组相比,ACA+EA 联合治疗在正常 Wistar 大鼠(-45%±3%比-19%±3%,  <0.001)和 SIIR 模型大鼠(-43%±2%比-16%±6%,  <0.001)中均具有更强的降糖作用。ACA+EA 组 SIIR 大鼠的血浆 FFA 水平显著降低(-48.9%±4.0%,  <0.001),IR 稳态模型评估(HOMA-IR)指数(-48.9%±4.0%,  <0.001)和胰岛素敏感性指数(102%±16.9%,  <0.001)显著改善,骨骼肌中胰岛素受体底物 1、葡萄糖转运蛋白 4 和过氧化物酶体增殖物激活受体 γ 蛋白表达显著增加。

结论

电针与 ACA 联合治疗比 ACA 单药治疗具有更强的降糖作用;这种联合治疗可能更有效地改善 SIIR 大鼠的 IR,这可能与降低血浆 FFA 水平和提高胰岛素信号蛋白有关。这种联合治疗在 2 型糖尿病(T2DM)患者中是否有效仍需进一步探讨。

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