Sapporo Diabetes and Thyroid Clinic, Sapporo, Japan.
Department of Rheumatology, Endocrinology, and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
J Diabetes Investig. 2021 Apr;12(4):651-657. doi: 10.1111/jdi.13375. Epub 2020 Sep 7.
AIMS/INTRODUCTION: Alcohol consumption has been reported to cause hypoglycemia. However, the mechanism involved has not been unequivocally established. This study comprised healthy volunteers. We carried out a prospective trial to compare the effects of glucose and alcohol consumption, alone or in combination, on glucose and lipid metabolism.
A 75-g oral glucose tolerance test (OGTT), a combined 75-g glucose plus 20-g alcohol tolerance test (OGATT) and a 20-g alcohol tolerance test (OATT) were carried out in the participants. Plasma glucose, insulin, triglyceride and ethanol concentrations during each test were compared.
We studied 10 participants. Their plasma glucose concentrations 15 and 30 min after the intake of 75 g of glucose were significantly higher during the OGATT than the OGTT. Hypoglycemia occurred in five participants after the OGATT, which was significantly more frequently than after the OGTT (P = 0.046). Hypoglycemia did not occur after the OATT, and the ethanol concentration was significantly lower after the OGATT than the OATT. The changes in triglyceride concentration from 30 min after the consumption of 75 g of glucose were significantly greater during the OGATT than the OGTT. The plasma insulin concentrations peaked after 60 min during both the OGTT and OGATT, and were significantly higher during the OGATT (P = 0.047). There were no differences between the two interventions in the Matsuda or disposition indexes.
Hypoglycemia occurred more frequently after the simultaneous consumption of alcohol plus glucose than after the consumption of glucose alone, suggesting that alcohol in the combination of glucose induces reactive hypoglycemia.
目的/引言:有报道称,饮酒会导致低血糖。然而,其涉及的机制尚未明确。本研究纳入了健康志愿者。我们进行了一项前瞻性试验,以比较单独或联合摄入葡萄糖和酒精对葡萄糖和脂质代谢的影响。
参与者接受了 75g 口服葡萄糖耐量试验(OGTT)、75g 葡萄糖加 20g 酒精耐量试验(OGATT)和 20g 酒精耐量试验(OATT)。比较了每次试验期间的血浆葡萄糖、胰岛素、甘油三酯和乙醇浓度。
我们研究了 10 名参与者。他们在摄入 75g 葡萄糖后 15 和 30 分钟时的血浆葡萄糖浓度在 OGATT 时明显高于 OGTT。OGATT 后有 5 名参与者出现低血糖,明显多于 OGTT(P=0.046)。OATT 后未发生低血糖,OGATT 后乙醇浓度明显低于 OATT。从摄入 75g 葡萄糖后 30 分钟起,OGATT 时甘油三酯浓度的变化明显大于 OGTT。OGTT 和 OGATT 时,血浆胰岛素浓度在 60 分钟时达到峰值,OGATT 时明显更高(P=0.047)。两种干预措施之间在 Matsuda 或处置指数方面没有差异。
与单独摄入葡萄糖相比,同时摄入酒精加葡萄糖后更频繁地发生低血糖,提示葡萄糖与酒精联合摄入会引起反应性低血糖。