Ritzel R, Orskov C, Holst J J, Nauck M A
Department of Medicine, Ruhr-University Bochum, Knappschafts-Krankenhaus, Germany.
Diabetologia. 1995 Jun;38(6):720-5. doi: 10.1007/BF00401846.
Intravenous infusions of glucagon-like peptide 1 (GLP-1) [7-36 amide] are glucose-dependently insulinotropic and glucagonostatic and normalize plasma glucose concentrations in non-insulin-dependent diabetic patients. It was the aim of this study to investigate whether subcutaneous GLP-1 [7-36 amide] also has an influence on insulin and glucagon secretion, and which doses are required for significant effects. Therefore, eight healthy volunteers (24 +/- 2 years, body mass index [BMI] 21.9 +/- 2.3 kg/m2) were studied in the fasting state on five occasions in randomized order. Placebo (0.9% NaCl with 1% human serum albumin) or GLP-1 [7-36 amide] in doses of 0.15, 0.5, 1.5 or 4.5 nmol/kg body weight (volume 1 ml or, at the highest dose, 2 ml) was administered subcutaneously. An intravenous glucose bolus (0.33 g/kg body weight) was injected 30 min later. Blood was drawn for the measurement of glucose, insulin, C-peptide, GLP-1 [7-36 amide], and glucagon using specific radioimmunoassays. There were dose-related increments in GLP-1 [7-36 amide] concentrations (p < 0.0001). However, basal values were reached again after 90-120 min. Before glucose administration, insulin (p < 0.0001) and C-peptide (p < 0.0004) increased, whereas glucagon (p = 0.0018) and glucose (p < 0.0001) decreased in a dose-dependent manner. After glucose stimulation, integrated increments in insulin (p = 0.0007) and C-peptide (p = 0.02) were augmented and kG-values increased (p < 0.0001) in a dose-related fashion. The extent of reactive hypoglycaemia was related to the GLP-1 [7-36 amide] dose.(ABSTRACT TRUNCATED AT 250 WORDS)
静脉输注胰高血糖素样肽1(GLP-1)[7-36酰胺]具有葡萄糖依赖性促胰岛素分泌和抑制胰高血糖素分泌的作用,可使非胰岛素依赖型糖尿病患者的血糖浓度恢复正常。本研究旨在探讨皮下注射GLP-1[7-36酰胺]是否也会影响胰岛素和胰高血糖素的分泌,以及产生显著效果所需的剂量。因此,对8名健康志愿者(24±2岁,体重指数[BMI]21.9±2.3kg/m²)在空腹状态下进行了5次随机研究。皮下注射安慰剂(含1%人血清白蛋白的0.9%氯化钠溶液)或剂量为0.15、0.5、1.5或4.5nmol/kg体重(体积1ml,最高剂量为2ml)的GLP-1[7-36酰胺]。30分钟后静脉注射葡萄糖推注(0.33g/kg体重)。使用特异性放射免疫分析法采集血液以测定葡萄糖、胰岛素、C肽、GLP-1[7-36酰胺]和胰高血糖素。GLP-1[7-36酰胺]浓度呈剂量相关增加(p<0.0001)。然而,90-120分钟后又恢复到基础值。在给予葡萄糖之前,胰岛素(p<0.0001)和C肽(p<0.0004)增加,而胰高血糖素(p=0.0018)和葡萄糖(p<0.0001)呈剂量依赖性降低。葡萄糖刺激后,胰岛素(p=0.0007)和C肽(p=0.02)的综合增加量增加,kG值呈剂量相关增加(p<0.0001)。反应性低血糖的程度与GLP-1[7-36酰胺]剂量有关。(摘要截短至250字)