Groop L, Tötterman K J, Harno K, Gordin A
Acta Med Scand. 1983;213(1):9-14. doi: 10.1111/j.0954-6820.1983.tb03681.x.
Two beta-blocking agents, non-selective propranolol and beta 1-selective metoprolol, were investigated with respect to their effect on glucose metabolism in 11 hypertensive, non-diabetic patients. They were randomly treated for two weeks in a double-blind cross-over manner with propranolol, metoprolol and placebo. Both drugs caused a small but significant increase in basal blood glucose values as compared with placebo (p less than 0.01). Metoprolol increased the blood glucose concentrations during the first 10 min of an i.v. glucose tolerance test (IVGTT) as compared with placebo (p less than 0.02) and propranolol (p less than 0.05). Propranolol raised only the blood glucose values during the later part of the IVGTT (p less than 0.01). The increase in blood glucose concentrations was, however, not associated with significant changes in peripheral insulin levels. The mean basal glucagon concentrations were lower during propranolol and metoprolol than during placebo (p less than 0.01). Propranolol also induced a more pronounced reduction of plasma glucagon than placebo (p less than 0.05) at 10 min of the IVGTT. The mean basal free fatty acid (FFA) concentrations were lower during propranolol (p less than 0.001) and metoprolol (p less than 0.05) than during placebo. Both drugs decreased the plasma levels of FFA during the first 10 min of the IVGTT as compared with placebo (p less than 0.01 and p less than 0.02, respectively). Pharmacological doses of propranolol and metoprolol increased blood glucose concentrations, decreased plasma glucagon and FFA concentrations, but had no effect on serum insulin levels in hypertensive, non-diabetic subjects.
研究了两种β受体阻滞剂，即非选择性的普萘洛尔和β1选择性的美托洛尔对11名高血压非糖尿病患者糖代谢的影响。他们以双盲交叉方式，分别接受普萘洛尔、美托洛尔和安慰剂治疗两周。与安慰剂相比，两种药物均使基础血糖值出现小幅但显著的升高（p<0.01）。与安慰剂（p<0.02）及普萘洛尔（p<0.05）相比，美托洛尔使静脉葡萄糖耐量试验（IVGTT）最初10分钟的血糖浓度升高。普萘洛尔仅使IVGTT后期的血糖值升高（p<0.01）。然而，血糖浓度的升高与外周胰岛素水平的显著变化无关。普萘洛尔和美托洛尔治疗期间的平均基础胰高血糖素浓度低于安慰剂治疗期间（p<0.01）。在IVGTT的10分钟时，普萘洛尔诱导的血浆胰高血糖素降低比安慰剂更显著（p<0.05）。普萘洛尔（p<0.001）和美托洛尔（p<0.05）治疗期间的平均基础游离脂肪酸（FFA）浓度低于安慰剂治疗期间。与安慰剂相比，两种药物在IVGTT最初10分钟均降低了血浆FFA水平（分别为p<0.01和p<0.02）。药理剂量的普萘洛尔和美托洛尔可升高高血压非糖尿病受试者的血糖浓度，降低血浆胰高血糖素和FFA浓度，但对血清胰岛素水平无影响。
