二肽基肽酶4抑制剂改善日本2型糖尿病患者的胰岛素抵抗：一项单臂研究，简要报告
Dipeptidyl peptidase 4 inhibitor improves insulin resistance in Japanese patients with type 2 diabetes: a single-arm study, a brief report.
作者信息
Okura Tsuyoshi, Fujioka Yohei, Nakamura Risa, Ito Yuichi, Kitao Sonoko, Anno Mari, Matsumoto Kazuhisa, Shoji Kyoko, Okura Hiroko, Matsuzawa Kazuhiko, Izawa Shoichiro, Ueta Etsuko, Kato Masahiko, Imamura Takeshi, Taniguchi Shin-Ichi, Yamamoto Kazuhiro
机构信息
Division of Cardiovascular Medicine, Endocrinology and Metabolism, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan.
School of Health Science, Faculty of Medicine, Tottori University, Yonago, Japan.
出版信息
Diabetol Metab Syndr. 2022 Jun 7;14(1):78. doi: 10.1186/s13098-022-00850-9.
BACKGROUND
Dipeptidyl peptidase 4 inhibitor (DPP4i) is an effective medicine for type 2 diabetes mellitus (T2DM). Some articles reported DPP4i improves insulin secretion and insulin resistance. However, these effects are not well established by glucose clamp test and test meal in Japanese. We investigated the effect of DPP4i on insulin resistance and insulin secretion by using the glucose clamp test and meal tolerance test (MTT).
METHODS
We performed a MTT, and the hyperinsulinemic-euglycemic clamp in 8 Japanese patients with T2DM. This study was a single-arm study. We measured fasting and postprandial glucose, insulin, incretins, and glucagon levels. We also measured serum adiponectin levels.
RESULTS
HbA1c was significantly decreased after 3 months. The fasting and postprandial glucose levels were significantly decreased. Fasting and postprandial insulin levels were not changed. The insulin resistance derived from the glucose clamp test was significantly improved. HOMA-IR was not significantly changed. GLP-1 and GIP were significantly increased but glucagon did not change. Adiponectin was not significantly changed.
CONCLUSIONS
Although the number of patients was very small, these results suggested that DPP4i treatment might improve insulin resistance without changing insulin secretion.
背景
二肽基肽酶4抑制剂（DPP4i）是治疗2型糖尿病（T2DM）的一种有效药物。一些文章报道DPP4i可改善胰岛素分泌和胰岛素抵抗。然而，在日本人群中，这些作用尚未通过葡萄糖钳夹试验和试餐试验得到充分证实。我们通过葡萄糖钳夹试验和餐耐量试验（MTT）研究了DPP4i对胰岛素抵抗和胰岛素分泌的影响。
方法
我们对8例日本T2DM患者进行了MTT和高胰岛素-正葡萄糖钳夹试验。本研究为单臂研究。我们测量了空腹和餐后血糖、胰岛素、肠促胰岛素和胰高血糖素水平。我们还测量了血清脂联素水平。
结果
3个月后糖化血红蛋白（HbA1c）显著降低。空腹和餐后血糖水平显著降低。空腹和餐后胰岛素水平未改变。葡萄糖钳夹试验得出的胰岛素抵抗显著改善。稳态模型评估的胰岛素抵抗（HOMA-IR）无显著变化。胰高血糖素样肽-1（GLP-1）和葡萄糖依赖性促胰岛素多肽（GIP）显著升高，但胰高血糖素未改变。脂联素无显著变化。
结论
尽管患者数量非常少，但这些结果表明DPP4i治疗可能改善胰岛素抵抗而不改变胰岛素分泌。
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