Dose-dependent effect of octreotide on insulin secretion after OGTT in obesity
Dose-dependent effect of octreotide on insulin secretion after OGTT in obesity
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DOI：
10.1159/000023120
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发表时间：
1998-01-01
期刊：
影响因子：
--
通讯作者：
Bollea, MR
中科院分区：
文献类型：
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作者：
Bertoli, A;Magnaterra, R;Bollea, MR
目的：评价长效生长抑素类似物奥曲肽(OCT)剂量增加对糖耐量和胰岛素分泌的急性影响。方法：皮下注射OCT 30min后，随机对受试者进行1次标准糖耐量试验和2次口服糖耐量试验。肥胖者服用10、25或50微克的OCT；对照组只服用10和25微克。15名肥胖者和10名对照组被研究；他们都有正常的糖耐量。分别于糖耐量试验后30、0、30、60、90、120、150、180分钟测定血糖和胰岛素水平。结果：结果显示，服用OCT后，对照组和肥胖组均出现糖耐量降低、血糖峰值延迟和晚期血糖值升高。肥胖组的空腹胰岛素分泌和刺激胰岛素分泌均高于对照组，且OCT抑制胰岛素分泌呈剂量依赖关系。结论：OCT的作用可能至少有两种不同的协同机制：(1)延迟葡萄糖吸收，表现为血糖峰值延迟；(2)直接或迷走神经介导的作用，表现为尽管晚期血糖水平升高，但曲线下面积减小。值得注意的是，低至10和25微克的OCT剂量足以抑制正常和肥胖受试者的胰岛素分泌。
Objective: The present study aimed at evaluating the acute effect of increasing doses of octreotide (OCT), a long-acting somatostatin analogue, on glucose tolerance and insulin secretion. Methods: A standard and two other oral glucose tolerance tests 30 min after subcutaneous administration of OCT were performed in randomized order in each subject. Obese subjects received 10, 25, or 50 mu g of OCT; control subjects received only 10 and 25 mu g. Fifteen obese and 10 control subjects were studied; all of them had a normal glucose tolerance. Plasma glucose and insulin levels were measured at times -30, 0, 30, 60, 90, 120, 150, and 180 min after the glucose tolerance test. Results: The results demonstrated that, following OCT administration, both control and obese subjects developed a reduced glucose tolerance, a delayed glycemic peak, and an increase of late plasma glucose values. Fasting as well as stimulated insulin secretions were higher in obese subjects as compared with controls, and insulin secretion was inhibited in a dose-dependent manner by OCT. Conclusions: These data indicate that the action of OCT might be due to at least two different cooperative mechanisms: (1) a delayed glucose absorption, as suggested by the delay of glycemic peak, and (2) a direct or vagal-mediated effect on p-cells, as suggested by the reduction of the area under the curve values in spite of the elevated late glycemic levels. It is noteworthy that doses of OCT as low as 10 and 25 mu g are sufficient to inhibit insulin secretion both in normal and obese subjects.