Yoo Soyeon, Kim Dongkyu, Koh Gwanpyo
Department of Internal Medicine, College of Medicine, Jeju National University, Jeju 63241, Korea.
Department of Internal Medicine, Jeju National University Hospital, Jeju 63241, Korea.
J Clin Med. 2021 Jun 4;10(11):2487. doi: 10.3390/jcm10112487.
We aimed to investigate the changes in glucagon levels in people with diabetes after the ingestion of a mixed meal and the correlations of variation in glucagon levels with incretin and clinico-biochemical characteristics.
Glucose, C-peptide, glucagon, intact glucagon-like peptide 1 (iGLP-1), and intact glucose-dependent insulinotropic polypeptide (iGIP) were measured in blood samples collected from 317 people with diabetes before and 30 min after the ingestion of a standard mixed meal. The delta (Δ) is the 30-min value minus the basal value.
At 30 min after meal ingestion, the glucagon level showed no difference relative to the basal value, whereas glucose, C-peptide, iGLP-1, and iGIP levels showed a significant increase. In univariate analysis, Δglucagon showed not only a strong correlation with HbA1c but also a significant correlation with fasting glucose, Δglucose, and estimated glomerular filtration rate. However, Δglucagon showed no significant correlations with ΔiGLP-1 and ΔiGIP. In the hierarchical multiple regression analysis, HbA1c was the only variable that continued to show the most significant correlation with Δglucagon.
People with diabetes showed no suppression of glucagon secretion after meal ingestion. Patients with poorer glycemic control may show greater increase in postprandial glucagon level, and this does not appear to be mediated by incretin.
我们旨在研究糖尿病患者摄入混合餐后胰高血糖素水平的变化，以及胰高血糖素水平变化与肠促胰岛素及临床生化特征之间的相关性。
采集317例糖尿病患者在摄入标准混合餐之前及之后30分钟的血样，检测其中的葡萄糖、C肽、胰高血糖素、完整的胰高血糖素样肽1（iGLP-1）和完整的葡萄糖依赖性促胰岛素多肽（iGIP）。差值（Δ）为30分钟时的值减去基础值。
摄入餐后30分钟时，胰高血糖素水平与基础值相比无差异，而葡萄糖、C肽、iGLP-1和iGIP水平显著升高。在单因素分析中，Δ胰高血糖素不仅与糖化血红蛋白（HbA1c）密切相关，还与空腹血糖、Δ葡萄糖及估算肾小球滤过率显著相关。然而，Δ胰高血糖素与ΔiGLP-1和ΔiGIP无显著相关性。在分层多元回归分析中，HbA1c是唯一继续与Δ胰高血糖素显示最显著相关性的变量。
糖尿病患者摄入餐后胰高血糖素分泌未受抑制。血糖控制较差的患者餐后胰高血糖素水平可能升高幅度更大，且这似乎并非由肠促胰岛素介导。
