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比较二甲双胍和利拉鲁肽对糖耐量受损大鼠心脏保护作用的评价。

Comparative evaluation of metformin and liraglutide cardioprotective effect in rats with impaired glucose tolerance.

机构信息

Almazov National Medical Research Centre, Saint-Petersburg, Russia.

Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russia.

出版信息

Sci Rep. 2021 Mar 23;11(1):6700. doi: 10.1038/s41598-021-86132-2.

Abstract

Impaired glucose tolerance (IGT) increases cardiovascular risk and can enlarge myocardial infarction (MI) incidence and severity. There is lack of information about cardioprotective potential of glucose-lowering drugs in IGT. We aimed to evaluate the sustainability of myocardium to ischemia-reperfusion injury in diabetic and IGT rats and to study cardioprotective action of metformin and liraglutide. Type 2 diabetes mellitus (DM) and IGT were modelled in Wistar rats by high-fat diet and streptozotocin + nicotinamide. 4 weeks after rats were divided into 4 groups: DM (without treatment) (n = 4), IGT (without treatment) (n = 4), IGT + MET (metformin 200 mg/kg per os once daily 8 weeks) (n = 4), IGT + LIRA (liraglutide 0.06 mg/kg s.c. once daily for 8 weeks) (n = 4). Control (n = 6) and high-fat diet (n = 8) groups were made for comparison. After 8 weeks ischemia-reperfusion injury in isolated hearts was performed. Hemodynamic parameters were evaluated and MI size was measured by staining of myocardium slices in triphenyltetrazolium chloride solution. Blood glucose level was measured during the study. Both IGT and DM led to similar worsening of hemodynamic parameters during ischemia-reperfusion period, in comparison with control group. MI size in IGT (56.76 (51.58; 69.07) %) and DM (57.26 (45.51; 70.08) %) groups was significantly larger than that in control group (42.98 (33.26; 61.84) %) and did not differ between each other. MI size in high-fat diet group (56.98 (47.11; 62.83) %) was as large as in IGT and DM groups (p > 0.05). MI size in IGT + MET (42.11 (38.08; 71.96) %) and IGT + LIRA (42.50 (31.37; 60.40) %) was smaller than in both DM and IGT groups (p < 0.05 for multiple comparison). Myocardium damage size did not differ in IGT + MET and IGT + LIRA groups (p >  0.05). Only LIRA, but not MET administration to IGT rats led to ischemic contracture reduction. Glycemic control was similarly satisfactory in IGT, IGT + MET, IGT + LIRA groups. Thus, IGT and DM have similarly pronounced negative influence on hemodynamics and MI size in rat transient global ischemia ex vivo. Obesity development also has negative impact on the MI size. Both MET and LIRA have infarct-limiting effect independent on their influence on glucose level. LIRA, but not MET, diminishes ischemic contracture in IGT rats.

摘要

糖耐量受损(IGT)会增加心血管风险,并可能扩大心肌梗死(MI)的发生率和严重程度。关于降低血糖药物在 IGT 中的心脏保护作用的信息还很缺乏。我们旨在评估糖尿病和 IGT 大鼠心肌对缺血再灌注损伤的耐受性,并研究二甲双胍和利拉鲁肽的心脏保护作用。通过高脂肪饮食和链脲佐菌素+烟酰胺在 Wistar 大鼠中建立 2 型糖尿病(DM)和 IGT 模型。4 周后,大鼠分为 4 组:DM(未治疗)(n=4)、IGT(未治疗)(n=4)、IGT+MET(二甲双胍 200mg/kg 口服,每日 1 次,共 8 周)(n=4)、IGT+LIRA(利拉鲁肽 0.06mg/kg 皮下注射,每日 1 次,共 8 周)(n=4)。设立对照组(n=6)和高脂肪饮食组(n=8)进行比较。在 8 周后进行离体心脏缺血再灌注损伤。评估血流动力学参数,并通过三苯基四唑氯溶液染色测量心肌切片的 MI 大小。在研究过程中测量血糖水平。与对照组相比,IGT 和 DM 均导致缺血再灌注期间血流动力学参数明显恶化。IGT(56.76(51.58;69.07)%)和 DM(57.26(45.51;70.08)%)组的 MI 大小明显大于对照组(42.98(33.26;61.84)%),且两组间无差异。高脂肪饮食组(56.98(47.11;62.83)%)的 MI 大小与 IGT 和 DM 组相似(p>0.05)。IGT+MET(42.11(38.08;71.96)%)和 IGT+LIRA(42.50(31.37;60.40)%)组的 MI 大小小于 DM 和 IGT 组(多重比较时,p<0.05)。IGT+MET 和 IGT+LIRA 组的心肌损伤大小无差异(p>0.05)。只有利拉鲁肽,而不是二甲双胍,可减少 IGT 大鼠的缺血性挛缩。IGT、IGT+MET 和 IGT+LIRA 组的血糖控制同样令人满意。因此,IGT 和 DM 对大鼠短暂全脑缺血的体外血流动力学和 MI 大小有相似的显著负面影响。肥胖的发展也对 MI 大小有负面影响。二甲双胍和利拉鲁肽都有独立于其对血糖水平影响的梗死限制作用。利拉鲁肽可减轻 IGT 大鼠的缺血性挛缩,而二甲双胍则没有。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6532/7987997/fdc8e93f7164/41598_2021_86132_Fig1_HTML.jpg

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