Preserved GLP-1 and exaggerated GIP secretion in type 2 diabetes and relationships with triglycerides and ALT
Preserved GLP-1 and exaggerated GIP secretion in type 2 diabetes and relationships with triglycerides and ALT
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DOI：
10.1530/eje-13-0487
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发表时间：
2013-10-01
影响因子：
5.8
通讯作者：
Dekker, Jacqueline M.
中科院分区：
文献类型：
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作者：
Alssema, Marjan;Rijkelijkhuizen, Josina M.;Dekker, Jacqueline M.
目的：1)比较糖尿病患者和正常血糖人群对口服葡萄糖和混合餐的胰岛素反应；2)探讨胰岛素反应与高甘油三酯血症和肝脂标志物丙氨酸氨基转移酶(ALT)的关系。设计：一项以人群为基础的研究。方法：年龄40~65岁的163例糖代谢正常者，20例中度高血糖者和20例2型糖尿病患者。参与者在不同的场合接受了混合餐和口服葡萄糖负荷。结果：与正常对照组比较，糖尿病患者口服葡萄糖后GLP-1分泌量(tAUC/h)增加(23.2pmol/L，95%可信区间为17.7~28.7)vs18.0(95%可信区间为16.9~19.1)，P<；糖尿病患者GIP分泌量在两种情况下均增加(口服葡萄糖82.9pmoL/L(55.9~109.8)vs47.1(43.8~50.4)；混合餐130.6(92.5~168.7)vs83.2(77.5~88.9)，P均<0.05)。口服葡萄糖后，GLP-1(每小时tAUC)与空腹甘油三酯呈负相关。GIP(每小时tAUC)与空腹和餐后甘油三酯呈正相关。空腹GIP水平升高与空腹及餐后甘油三酯水平及ALT升高有关。结论：本研究证实2型糖尿病患者GLP-1分泌基本保持，GIP分泌被夸大。GLP-1和GIP代谢与脂肪代谢和肝脏脂肪堆积的差异机制值得进一步研究。
Objective: To i) compare incretin responses to oral glucose and mixed meal of diabetic patients with the normoglycaemic population and ii) to investigate whether incretin responses are associated with hypertriglyceridaemia and alanine aminotransferase (ALT) as liver fat marker.Design: A population-based study.Methods: A total of 163 persons with normal glucose metabolism (NGM), 20 with intermediate hyperglycaemia and 20 with type 2 diabetes aged 40-65 years participated. Participants received a mixed meal and oral glucose load on separate occasions. Glucagon-like peptide 1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and glucagon profiles were analysed as total area under the curve (tAUC) and incremental area under the curve.Results: In diabetic patients compared with persons with NGM, we found increased GLP-1 secretion (tAUC per hour) following oral glucose (23.2 pmol/l (95% CI 17.7-28.7) vs 18.0 (95% CI 16.9-19.1), P < 0.05) but not after the mixed meal. GIP secretion among diabetic patients was increased on both occasions (82.9 pmol/l (55.9-109.8) vs 47.1 (43.8-50.4) for oral glucose and 130.6 (92.5-168.7) vs 83.2 (77.5-88.9) for mixed meal, both P < 0.05). After oral glucose, GLP-1 (tAUC per hour) was inversely related to fasting triglycerides. GIP (tAUC per hour) was positively related to fasting and postprandial triglycerides. Higher fasting GIP levels were related to higher fasting and postprandial triglyceride levels and ALT.Conclusion: This study confirms that in type 2 diabetes, GLP-1 secretion is generally preserved and that GIP secretion is exaggerated. The mechanism underlying the divergent associations of GLP-1 and GIP metabolism with fat metabolism and liver fat accumulation warrants further study.