Yuan Robin K, Zitting Kirsi-Marja
Department of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA.
Curr Sleep Med Rep. 2025 Dec;11. doi: 10.1007/s40675-025-00337-9. Epub 2025 May 28.
Little is known about how incretins interact with sleep and circadian factors, both of which influence metabolic outcomes. We review evidence that sleep, circadian rhythms, and their disturbances impact incretin secretion and discuss clinical applications for GLP-1/GIP-RA drugs in sleep medicine and areas for future research.
GLP-1 secretion exhibits a circadian rhythm which may be disrupted by high-fat diet, meal timing, and gut dysbiosis. Insufficient sleep may alter the timing of postprandial GLP-1 release, and the circadian rhythm of GLP-1 secretion is blunted in patients with metabolic conditions such as obesity or diabetes. Lastly, the FDA has approved the use of tirzepatide (a GLP-1/GIP-RA drug) for treating obstructive sleep apnea.
Evidence suggests that sleep and circadian rhythms impact the incretin system, although findings are somewhat mixed due to the variety of methods employed. In light of the growing interest in new clinical applications for incretin therapies, more research is needed to fully understand the relationship between sleep, circadian rhythms, and incretin secretion.
关于肠促胰岛素如何与睡眠和昼夜节律因素相互作用，目前了解甚少，而这两种因素都会影响代谢结果。我们回顾了睡眠、昼夜节律及其紊乱影响肠促胰岛素分泌的证据，并讨论了GLP-1/GIP-RA药物在睡眠医学中的临床应用以及未来的研究方向。
GLP-1分泌呈现昼夜节律，高脂饮食、进餐时间和肠道菌群失调可能会破坏这种节律。睡眠不足可能会改变餐后GLP-1释放的时间，在肥胖或糖尿病等代谢性疾病患者中，GLP-1分泌的昼夜节律会减弱。最后，美国食品药品监督管理局（FDA）已批准使用替尔泊肽（一种GLP-1/GIP-RA药物）治疗阻塞性睡眠呼吸暂停。
有证据表明睡眠和昼夜节律会影响肠促胰岛素系统，不过由于采用的方法多种多样，研究结果有些参差不齐。鉴于对肠促胰岛素疗法新临床应用的兴趣日益浓厚，需要更多研究来全面了解睡眠、昼夜节律和肠促胰岛素分泌之间的关系。
