Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Physiol Rep. 2023 Jan;11(2):e15577. doi: 10.14814/phy2.15577.
Glucose homeostasis is the maintenance and regulation of blood glucose concentration within a tight physiological range, essential for the functioning of most tissues and organs. This is primarily achieved by pancreatic secretion of insulin and glucagon. Deficient pancreatic endocrine function, coupled with or without peripheral insulin resistance leads to prolonged hyperglycemia with chronic impairment of glucose homeostasis, most commonly seen in diabetes mellitus. High protein diets (HPDs) are thought to modulate glucose homeostasis through various metabolic pathways. Insulin secretion can be directly modulated by the amino acid products of protein digestion, which activate nutrient receptors and nutrient transporters expressed by the endocrine pancreas. Insulin secretion can also be modulated indirectly, through incretin release from enteroendocrine cells, and via vagal neuronal pathways. Additionally, glucose homeostasis can be promoted by the satiating effects of anorectic hormones released following HPD consumption. This review summarizes the insulinotropic mechanisms by which amino acids and HPDs may influence glucose homeostasis, with a particular focus on their applicability in the management of Type 2 diabetes mellitus.
葡萄糖稳态是指在严格的生理范围内维持和调节血糖浓度，这对大多数组织和器官的正常功能至关重要。这主要是通过胰腺分泌胰岛素和胰高血糖素来实现的。胰腺内分泌功能不足，伴或不伴有外周胰岛素抵抗，导致长期高血糖，葡萄糖稳态慢性受损，最常见于糖尿病。高蛋白饮食（HPD）被认为通过多种代谢途径来调节葡萄糖稳态。蛋白质消化的氨基酸产物可以直接调节胰岛素的分泌，这些产物激活内分泌胰腺表达的营养受体和营养转运体。胰岛素的分泌也可以通过肠内分泌细胞分泌的肠促胰岛素和通过迷走神经途径间接调节。此外，高蛋白饮食摄入后，厌食激素的释放会产生饱腹感，从而促进葡萄糖稳态。本综述总结了氨基酸和 HPD 可能影响葡萄糖稳态的胰岛素促分泌机制，特别关注它们在 2 型糖尿病管理中的应用。
