Schmitz O, Nyholm B, Orskov L, Gravholt C, Møller N
Medical Department M (Endocrinology and Diabetes), Aarhus Kommunehospital, University Hospital of Aarhus, Denmark.
Diabet Med. 1997 Jun;14 Suppl 2:S19-23. doi: 10.1002/(sici)1096-9136(199706)14:2+<s19::aid-dia400>3.3.co;2-w.
Since the discovery of the pancreatic islet hormone amylin in 1987, its metabolic effects have been investigated in a number of studies in animals and humans. Data from some early animal studies suggested that amylin might be associated with the development of insulin resistance, but other studies found that amylin had no effect on insulin sensitivity. More recently, studies performed using the human amylin analogue pramlintide in patients with Type 1 diabetes found that the hormone has no influence on either insulin-stimulated glucose uptake or the restraining effect of insulin on hepatic glucose production during periods of euglycaemia. Furthermore, during insulin-induced hypoglycaemia, pramlintide appears to increase the plasma concentrations of cortisol and growth hormone, and to stimulate the release of the gluconeogenic substrate lactate by the skeletal muscles. Taken together with evidence that, in short-term studies, pramlintide improved glycaemic control in patients with Type 1 diabetes who were also treated with insulin, these data suggest that pramlintide may have a role in the management of patients with diabetes. However, longer-term studies are required to ascertain whether these findings are sustained over time.
自1987年发现胰岛激素胰淀素以来，已在多项动物和人体研究中对其代谢作用进行了调查。一些早期动物研究的数据表明，胰淀素可能与胰岛素抵抗的发展有关，但其他研究发现胰淀素对胰岛素敏感性没有影响。最近，在1型糖尿病患者中使用人胰淀素类似物普兰林肽进行的研究发现，在血糖正常期间，该激素对胰岛素刺激的葡萄糖摄取或胰岛素对肝葡萄糖生成的抑制作用均无影响。此外，在胰岛素诱导的低血糖期间，普兰林肽似乎会增加皮质醇和生长激素的血浆浓度，并刺激骨骼肌释放糖异生底物乳酸。结合短期研究中普兰林肽改善了同时接受胰岛素治疗的1型糖尿病患者血糖控制的证据，这些数据表明普兰林肽可能在糖尿病患者的管理中发挥作用。然而，需要进行长期研究以确定这些发现是否能长期持续。
