阿卡波糖对糖耐量受损受试者胰岛素敏感性的影响。
The effect of acarbose on insulin sensitivity in subjects with impaired glucose tolerance.
作者信息
Chiasson J L, Josse R G, Leiter L A, Mihic M, Nathan D M, Palmason C, Cohen R M, Wolever T M
机构信息
Research Center, Hôtel-Dieu de Montréal, Toronto, Canada.
出版信息
Diabetes Care. 1996 Nov;19(11):1190-3. doi: 10.2337/diacare.19.11.1190.
OBJECTIVE
To study the effect of acarbose, an alpha-glucosidase inhibitor, on postprandial plasma glucose and insulin and insulin sensitivity in subjects with impaired glucose tolerance (IGT).
RESEARCH DESIGN AND METHODS
Subjects with IGT were randomly treated in a double-blind fashion with placebo (n = 10) or acarbose (n = 8) at 100 mg t.i.d. for 4 months. All subjects were submitted before randomization and at the end of the study to a standardized breakfast and a 12-h daytime plasma glucose and plasma insulin profile, and insulin sensitivity was measured as steady-state plasma glucose (SSPG) using the insulin suppression test.
RESULTS
While placebo had no effect on postprandial plasma glucose and plasma insulin incremental area under the curve (AUC) (3.03 +/- 0.5 vs. 3.76 +/- 0.6 mmol.h-1.l-1, P = NS; 1,488 +/- 229 vs. 1,609 +/- 253 pmol.h-1.l-1, P = NS), acarbose resulted in a significant reduction for both glucose (1.44 +/- 0.3 vs. 4.45 +/- 0.9 mmol.h-1.l-1, P = 0.002) and insulin (626.7 +/- 104.3 vs. 1,338.3 +/- 220.5 pmol.h-1.l-1, P = 0.003). The reduction in 12-h plasma glucose and insulin AUC on acarbose (11.2 +/- 2.1 mmol.h-1.l-1 and 7.5 +/- 0.7 nmol.h-1.l-1) was significantly greater than that on placebo (4.0 +/- 1.6 mmol.h-1.l-1 and 0.8 +/- 0.4 nmol.h-1.l-1) (P = 0.014 and 0.041). While SSPG was not affected by placebo (13.9 +/- 0.4 vs. 13.8 +/- 0.3 mmol/l; P = NS), it was significantly improved by acarbose (10.9 +/- 1.4 vs. 13.1 +/- 1.5 mmol/l, P < 0.004) and was also significantly different from placebo at 4 months (P < 0.02).
CONCLUSIONS
It is concluded that in subjects with IGT, acarbose treatment decreases postprandial plasma glucose and insulin and improves insulin sensitivity. Acarbose may therefore be potentially useful to prevent the progression of IGT to NIDDM.
目的
研究α-葡萄糖苷酶抑制剂阿卡波糖对糖耐量受损（IGT）患者餐后血糖、胰岛素及胰岛素敏感性的影响。
研究设计与方法
IGT患者被随机分为两组，采用双盲法，一组服用安慰剂（n = 10），另一组服用阿卡波糖（n = 8），剂量为100 mg，每日3次，共4个月。所有受试者在随机分组前及研究结束时均接受标准化早餐，并进行12小时日间血糖和血浆胰岛素监测，采用胰岛素抑制试验测定胰岛素敏感性，以稳态血糖（SSPG）表示。
结果
安慰剂对餐后血糖及血浆胰岛素曲线下增量面积（AUC）无影响（3.03±0.5 vs. 3.76±0.6 mmol·h⁻¹·L⁻¹，P = NS；1,488±229 vs. 1,609±253 pmol·h⁻¹·L⁻¹，P = NS），而阿卡波糖可使血糖（1.44±0.3 vs. 4.45±0.9 mmol·h⁻¹·L⁻¹，P = 0.002）和胰岛素（626.7±104.3 vs. 1,338.3±220.5 pmol·h⁻¹·L⁻¹，P = 0.003）显著降低。阿卡波糖治疗组12小时血糖和胰岛素AUC的降低幅度（11.2±2.1 mmol·h⁻¹·L⁻¹和7.5±0.7 nmol·h⁻¹·L⁻¹）显著大于安慰剂组（4.0±1.6 mmol·h⁻¹·L⁻¹和0.8±0.4 nmol·h⁻¹·L⁻¹）（P = 0.014和0.041）。安慰剂对SSPG无影响（13.9±0.4 vs. 13.8±0.3 mmol/L；P = NS），而阿卡波糖可显著改善SSPG（10.9±1.4 vs. 13.1±1.5 mmol/L，P < 0.004），且在4个月时与安慰剂组相比差异也有统计学意义（P < 0.02）。
结论
得出结论，在IGT患者中，阿卡波糖治疗可降低餐后血糖和胰岛素水平，并改善胰岛素敏感性。因此，阿卡波糖可能对预防IGT进展为非胰岛素依赖型糖尿病（NIDDM）有潜在作用。
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