The sodium-glucose cotransporter 2 inhibitor ipragliflozin improves liver function and insulin resistance in Japanese patients with type 2 diabetes.
The sodium-glucose cotransporter 2 inhibitor ipragliflozin improves liver function and insulin resistance in Japanese patients with type 2 diabetes.
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DOI：
10.1038/s41598-022-05704-y
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发表时间：
2022-02-03
影响因子：
4.6
通讯作者：
Yamamoto K
中科院分区：
文献类型：
--
作者：
Okura T;Fujioka Y;Nakamura R;Kitao S;Ito Y;Anno M;Matsumoto K;Shoji K;Matsuzawa K;Izawa S;Okura H;Ueta E;Kato M;Imamura T;Taniguchi SI;Yamamoto K
钠-葡萄糖协同转运蛋白 2 抑制剂 (SGLT2i) 治疗是 2 型糖尿病 (T2DM) 的一种治疗方法。一些报告表明，SGLT2i 治疗可改善胰岛素抵抗；然而，很少有研究通过葡萄糖钳夹法评估胰岛素抵抗。肝脏胰岛素清除率（HIC）是T2DM的一个新的病理生理机制。 SGLT2i 治疗对肝脏胰岛素清除率和胰岛素抵抗的影响尚不清楚。我们研究了 SGLT2i 治疗对胰岛素抵抗、胰岛素分泌、肠促胰岛素水平、身体成分和肝脏胰岛素清除率的影响。我们对 9 名 T2DM 患者进行了膳食耐受试验 (MTT) 和高胰岛素正常血糖钳夹试验。给予伊格列净（50 mg/天），4 个月后进行 MTT 和钳夹试验。我们将 HIC 计算为餐后 C 肽 AUC 与胰岛素 AUC 之比。我们还在 MTT 期间测量了 GLP-1、GIP 和胰高血糖素水平。治疗 4 个月后，体重和糖化血红蛋白 (HbA1c) 有所下降，但并不显着。餐后血糖、空腹胰岛素和餐后胰岛素均显着降低。葡萄糖钳夹试验的胰岛素抵抗没有改变，但HOMA-IR和胰岛素敏感性指数显着改善。肠促胰岛素和胰高血糖素水平没有改变。肝脏胰岛素清除率显着增加，但全身胰岛素清除率没有改变。 FIB-4指数和脂肪肝指数显着降低。 HOMA-β和胰岛素生成指数没有变化，但C肽指数显着升高。尽管患者数量较少，但这些结果表明，SGLT2i 治疗改善了肝功能，降低了肝脏胰岛素抵抗，并增加了肝脏胰岛素清除率，尽管体重减轻幅度较小。
Sodium–glucose cotransporter 2 inhibitor (SGLT2i) treatment is a therapeutic approach for type 2 diabetes mellitus (T2DM). Some reports have shown that SGLT2i treatment improves insulin resistance; however, few studies have evaluated insulin resistance by the glucose clamp method. Hepatic insulin clearance (HIC) is a new pathophysiological mechanism of T2DM. The effect of SGLT2i treatment on hepatic insulin clearance and insulin resistance is not well known. We investigated the effect of SGLT2i treatment on insulin resistance, insulin secretion, incretin levels, body composition, and hepatic insulin clearance. We conducted a meal tolerance test (MTT) and a hyperinsulinemic-euglycemic clamp test in 9 T2DM patients. Ipragliflozin (50 mg/day) was administered, and the MTT and clamp test were performed after 4 months. We calculated HIC as the postprandial C-peptide AUC-to-insulin AUC ratio. We also measured GLP-1, GIP, and glucagon levels during the MTT. Body weight and HbA1c were decreased, although not significantly, after 4 months of treatment. Postprandial glucose, fasting insulin and postprandial insulin were significantly decreased. Insulin resistance with the glucose clamp was not changed, but the HOMA-IR and insulin sensitivity indices were significantly improved. Incretin and glucagon levels were not changed. Hepatic insulin clearance was significantly increased, but whole-body insulin clearance was not changed. The FIB-4 index and fatty liver index were significantly reduced. The HOMA-beta and insulinogenic indices were not changed, but the C-peptide index was significantly increased. Although the number of patients was small, these results suggested that SGLT2i treatment improved liver function, decreased hepatic insulin resistance, and increased hepatic insulin clearance, despite the small weight reduction.
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影响因子：
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影响因子：
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影响因子：
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作者：
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