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目的在不同食物负荷情况下,观察阿卡波糖对T2DM患者血清胰升糖素样肽-1(GLP-1)和抑胃肽(GIP)水平的影响。方法新诊断T2DM患者32例,随机分为OGTT组和混合餐试验(MIX)组,使用阿卡波糖片治疗共6周。在服药前1周、第一次服药及治疗6周后行OGTT或MIX,试验时检测0、15、30、60、90、120 min PG、GIP、GLP-1。结果(1)OGTT组与MIX组均随机入组16例,平均年龄分别为(51.7±10.4)、(51.8±11.7)岁。(2)首次使用阿卡波糖治疗,MIX组负荷后PG、GIP均有下降,其中15、30、60、90、120 min PG,15、30、60、90 min GIP,PG、GIP曲线下面积(AUC)比较,差异有统计学意义(P<0.05);MIX组90 min GLP-1较治疗前升高(P<0.05)。OGTT组各点PG、GLP-1、GIP水平及AUC与治疗前比较,差异无统计学意义。(3)治疗6周后,MIX组负荷后PG较治疗前下降,GIP水平随着PG下降,在15、30、60、90 min时较治疗前下降(P<0.05)。MIX组90 min GLP-1较治疗前升高(P<0.05)。OGTT组各点GLP-1、GIP水平及AUC与治疗前比较,差异无统计学意义。结论在不同种类糖负荷下,阿卡波糖对肠促胰岛素的影响可能不同。在复合碳水化合物负荷下,阿卡波糖可能影响GLP-1晚相分泌水平,而GIP可随PG水平的下降而降低。
Objective To observe the effects of acarbose on the levels of serum glucagon-like peptide-1 (GLP-1) and gastric inhibitory peptide (GIP) in T2DM patients under different food loads. Methods Thirty-two newly diagnosed T2DM patients were randomly divided into OGTT group and mixed meal test group (MIX), and treated with acarbose for 6 weeks. One week before taking the drug, the patients were given OGTT or MIX for 6 weeks after the first medication and treatment. PG, GIP and GLP-1 were tested at 0, 15, 30, 60, 90 and 120 minutes. Results (1) OGTT group and MIX group were randomly enrolled in 16 cases, the average age were (51.7 ± 10.4), (51.8 ± 11.7) years old. (2) The first use of acarbose treatment, MIX group after loading PG, GIP decreased, 15,30,60,90,120 min PG, 15,30,60,90 min GIP, PG, GIP curve (AUC), the difference was statistically significant (P <0.05). The GLP-1 in MIX group at 90 min was higher than that before treatment (P <0.05). OGTT group points PG, GLP-1, GIP levels and AUC compared with before treatment, the difference was not statistically significant. (3) After 6 weeks of treatment, the PG in the MIX group decreased compared with that before the treatment, and the GIP level decreased with PG decreased at 15, 30, 60, and 90 minutes (P <0.05). GLP-1 at 90 min in MIX group was higher than that before treatment (P <0.05). OGTT group at each point GLP-1, GIP levels and AUC compared with before treatment, the difference was not statistically significant. Conclusions The effect of acarbose on incretin may be different under different kinds of sugar load. Acarbose may affect late phase secretion of GLP-1 under complex carbohydrate load, whereas GIP may decrease with decreasing PG level.