Additive effects of glucagon-like peptide 1 and pioglitazone in patients with type 2 diabetes.
Additive effects of glucagon-like peptide 1 and pioglitazone in patients with type 2 diabetes.
复制标题
胰高血糖素样肽 1 和吡格列酮对 2 型糖尿病患者的相加作用。
作者：
M. Zander;A. Christiansen;S. Madsbad;J. Holst
目的
评价吡格列酮联合胰高血糖素样肽（GLP）-1治疗2型糖尿病的疗效。
研究设计和方法
2型糖尿病患者（BMI 32.7 +/- 1.3 kg/m2，空腹血糖13.5 +/- 1.2 mmol/l）随机接受四种不同的治疗方案：盐水治疗，GLP-1连续皮下输注单药治疗（4.8 pmol x kg（-1）x min（-1）），吡格列酮单药治疗（30 mg Actos片剂），GLP-1和吡格列酮联合治疗。观察时间为48 h。终点为血糖、胰岛素、胰高血糖素、游离脂肪酸（FFA）和食欲感觉的血浆水平。
结果
空腹血糖从13.5 +/- 1.2 mmol/l（生理盐水）降至11.7 +/- 1.2（GLP-1）和11.5 +/- 1.2（吡格列酮），并进一步降至9.9 +/- 1.0（联合用药）（P < 0.001）。8小时平均血糖水平从13.7 +/- 1.1 mmol/l（生理盐水）降至10.6 +/- 1.0（GLP-1）和12.0 +/- 1.2（吡格列酮），并进一步降至9.5 +/- 0.8（联合用药）（P < 0.0001）。与吡格列酮单药治疗相比，GLP-1单药治疗期间胰岛素水平升高（P < 0.01）。与生理盐水和吡格列酮单药治疗相比，GLP-1和联合治疗组的胰高血糖素水平降低（P < 0.01）。与生理盐水相比，早餐期间的FFA（曲线下面积，0-3 h）在联合治疗中减少（P = 0.03）。GLP-1单药治疗组和联合治疗组的食欲明显下降（P < 0.05）。
结论
GLP-1和吡格列酮显示出相加的降糖作用。因此，这两种药物的组合可能是治疗2型糖尿病的有价值的治疗方法。
OBJECTIVE
To evaluate the effect of combination therapy with pioglitazone and glucagon-like peptide (GLP)-1 in patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS
Eight patients with type 2 diabetes (BMI 32.7 +/- 1.3 kg/m(2) and fasting plasma glucose 13.5 +/- 1.2 mmol/l) underwent four different treatment regimens in random order: saline therapy, monotherapy with continuous subcutaneous infusion of GLP-1 (4.8 pmol x kg(-1) x min(-1)), monotherapy with pioglitazone (30-mg tablet of Actos), and combination therapy with GLP-1 and pioglitazone. The observation period was 48 h. End points were plasma levels of glucose, insulin, glucagon, free fatty acids (FFAs), and sensation of appetite.
RESULTS
Fasting plasma glucose decreased from 13.5 +/- 1.2 mmol/l (saline) to 11.7 +/- 1.2 (GLP-1) and 11.5 +/- 1.2 (pioglitazone) and further decreased to 9.9 +/- 1.0 (combination) (P < 0.001). Eight-hour mean plasma glucose levels were reduced from 13.7 +/- 1.1 mmol/l (saline) to 10.6 +/- 1.0 (GLP-1) and 12.0 +/- 1.2 (pioglitazone) and were further reduced to 9.5 +/- 0.8 (combination) (P < 0.0001). Insulin levels increased during monotherapy with GLP-1 compared with monotherapy with pioglitazone (P < 0.01). Glucagon levels were reduced in GLP-1 and combination therapy compared with saline and monotherapy with pioglitazone (P < 0.01). FFAs during breakfast (area under the curve, 0-3 h) were reduced in combination therapy compared with saline (P = 0.03). Sensation of appetite was reduced during monotherapy with GLP-1 and combination therapy (P < 0.05).
CONCLUSIONS
GLP-1 and pioglitazone show an additive glucose-lowering effect. A combination of the two agents may, therefore, be a valuable therapeutic approach for the treatment of type 2 diabetes.
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影响因子：
5.8
作者：
REAVEN, GM;CHEN, YDI;JASPAN, JB
通讯作者：
JASPAN, JB
曲格列酮治疗 2 型糖尿病的作用机制。
影响因子：
7.7
作者：
Petersen,KF;Krssak,M;Inzucchi,S;Cline,GW;Dufour,S;Shulman,GI
通讯作者：
Shulman,GI
DOI：
10.1152/ajpendo.1999.276.6.e1055
发表时间：
1999-06-01
影响因子：
5.1
作者：
Carpentier, A;Mittelman, SD;Lewis, GF
通讯作者：
Lewis, GF
影响因子：
7.7
作者：
Xu, G;Stoffers, DA;Bonner-Weir, S
通讯作者：
Bonner-Weir, S
影响因子：
158.5
作者：
Inzucchi, SE;Maggs, DG;Shulman, GI
通讯作者：
Shulman, GI