Department of Biochemistry, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara, Gujarat, 390002, India.
J Endocrinol Invest. 2023 Aug;46(8):1597-1612. doi: 10.1007/s40618-023-02014-6. Epub 2023 Jan 24.
Type 2 diabetes (T2D) is an endocrine disorder characterized by hyperglycemia, insulin resistance, dysregulated glucose and lipid metabolism, reduced pancreatic β-cell function and mass, and a reduced incretin effect. Circadian rhythm disruption is associated with increased T2D risk. We have investigated the therapeutic potential of a combination of melatonin (M) and sitagliptin (S), a dipeptidyl peptidase IV (DPP-IV) inhibitor, in the amelioration of T2D manifestations in high-fat diet (HFD) induced T2D mouse model and also on β-cell proliferation under gluco-lipotoxicity stress in vitro.
For in vivo study, mice were fed with HFD for 25 weeks to induce T2D and were treated with monotherapies and S + M for four weeks. For the in vitro study, primary mouse islets were exposed to normal glucose and high glucose + palmitate to induce gluco-lipotoxic stress.
Our results suggest that monotherapies and S + M improve metabolic parameters and glyco-lipid metabolism in the liver and adipose tissue, respectively, and improve mitochondrial function in the skeletal muscle. Moreover, it increases peripheral insulin sensitivity. Our in vitro and in vivo studies suggest that β-cell mass was preserved in all the drug-treated groups.
The combination treatment is superior to monotherapies in the management of T2D.
2 型糖尿病(T2D)是一种以内分泌紊乱为特征的疾病,其特点是高血糖、胰岛素抵抗、葡萄糖和脂质代谢失调、胰腺β细胞功能和数量减少以及肠促胰岛素效应降低。昼夜节律紊乱与 T2D 风险增加有关。我们研究了褪黑素(M)和二肽基肽酶-4(DPP-4)抑制剂西他列汀(S)联合治疗在改善高脂肪饮食(HFD)诱导的 T2D 小鼠模型中 T2D 表现的治疗潜力,以及在体外糖脂毒性应激下对β细胞增殖的影响。
在体内研究中,用 HFD 喂养小鼠 25 周以诱导 T2D,并进行单药治疗和 S+M 治疗 4 周。在体外研究中,将原代小鼠胰岛暴露于正常葡萄糖和高葡萄糖+棕榈酸中以诱导糖脂毒性应激。
我们的结果表明,单药治疗和 S+M 分别改善了代谢参数和肝脏及脂肪组织中的糖脂代谢,并改善了骨骼肌中的线粒体功能。此外,它还提高了外周胰岛素敏感性。我们的体内和体外研究表明,所有药物治疗组的β细胞质量都得到了保留。
联合治疗在 T2D 的治疗中优于单药治疗。