摘要
目的比较瑞格列奈、格列吡嗪速释片、格列吡嗪控释片、格列本脲4种胰岛素促泌剂对胰岛β细胞分泌胰岛素的影响。方法以静脉葡萄糖耐量试验(IVGTT)不同时相的胰岛素分泌曲线下面积(AUC)评价6名健康者和10例初发2型糖尿病患者胰岛β细胞分泌功能。每例受试者口服安慰剂、0.5mg瑞格列奈、5 mg格列吡嗪速释片、5 mg格列吡嗪控释片、2.5 mg格列本脲,以IVGTT时的胰岛素曲线下面积AUC0-19 min代表1相分泌量,AUC19-180 min代表2相分泌量,AUC0-180 min代表分泌总量。结果在两组受试者中,4种药物皆使胰岛素AUC0-180 min明显增加且大于安慰剂组(均P<0.05)。瑞格列奈使胰岛素AUC0-19 min明显增加并高于安慰剂组(P<0.05);格列吡嗪速释片及控释片也使胰岛素AUC0-19min增加,但两者增加比例均无统计学意义(均P>0.05),相反促进胰岛素AUC19-180 min作用更明显(均P<0.05)。而格列本脲对胰岛素AUC0-19 min作用甚微,对胰岛素AUC19-180min作用最大。结论瑞格列奈以促进胰岛素1相分泌为主,格列吡嗪对胰岛素1相和2相分泌皆有促进作用,且控释片和速释片间差异无统计学意义。格列本脲以促进2相分泌为主。
Objective To compare the effects of 4 insulin secretagogues: repaglinide, glibenclamide, glipizide XL and glipizide on insulin secretion of islet β-cells. Methods Ten newly-diagnosed type 2 diabetic patients and six control subjects received the intravenous glucose tolerance test (IVGTT). Each subject received placebo, 0.5 mg repaglinide, 2.5 mg glibenclamide, 5 mg glipizide XL and 5 mg glipizide. Insulin secretion was analyzed as first phase, late phase and total insulin secretion by calculating insulin area under curve (AUCs) for the first 19 minutes (AUC 0-19 min), the last 161 minutes (AUC 19-180 min) and the total 180 minutes (AUC 0-180 min) respectively. Results In both of the two groups, insulin AUC 0-180min with all the 4 secretagogues were significantly higher than placebo (all P<0.05). The first phase insulin output AUC 0-19minwith repaglinide reached significant difference against placebo(P<0.05) and while the other three sulfonylurea drugs failed to do so (all P<0.05). The sulfonylurea drugs significantly increased the insulin output in the late phase, with insulin in AUC 19-180 min being higher than that of placebo(all P<0.05), especially in the case of glibenclamide. Conclusion Repaglinide mainly enhances the first phase insulin secretion. Glipizide XL and Glipizide enhance both phases of insulin secretion,and no significant difference of effects is found between these two preparations. Glibenclamide mainly enhances the late phase insulin secretion.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2005年第3期206-210,共5页
Chinese Journal of Endocrinology and Metabolism
基金
国家自然科学基金(30270625)
上海市教委曙光学者计划资助
关键词
胰岛素促泌剂
胰岛Β细胞
胰岛素
瑞格列奈
格列吡嗪速释片
Insulin secretagogues
Islet β-cells
Insulin
Sulfonylurea compounds
Postprandial hyperglycemia
Prandial glucose regulator
