血管紧张素受体奈普利素抑制剂对2型糖尿病患者血清c肽水平的影响。

IF 1.2 Q4 ENDOCRINOLOGY & METABOLISM
Diabetology International Pub Date : 2024-10-18 eCollection Date: 2025-01-01 DOI:10.1007/s13340-024-00761-2
Tatsuya Ishibashi, Nobuyuki Nishi, Masanori Kita, Satomi Uenoyama, Tomomi Nakao, Ken Takeshima, Yasushi Furukawa, Shuhei Morita, Hiroto Furuta, Tokio Sanke, Taka-Aki Matsuoka
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引用次数: 0

摘要

Sacubitril/缬沙坦是一种血管紧张素受体neprilysin抑制剂(ARNI),在心力衰竭和高血压的治疗中越来越常见。Neprilysin在肾小管中高度表达,并且有报告显示在给予ARNI后尿c肽反应性(CPR)水平增加。然而,ARNI对血清CPR水平(糖尿病胰岛素分泌的关键指标)的影响仍未得到充分研究。我们评估了ARNI对2型糖尿病患者血清CPR水平的影响及其对内源性胰岛素分泌评估的影响。我们回顾性调查了两家医院的2型糖尿病患者的医疗记录,在给予ARNI之前和之后测量了空腹血糖和血清CPR水平。所有符合标准的11名患者(5名男性,6名女性)在服用ARNI后显示空腹血清CPR水平中位数增加。中位数从1.78 ng/mL (IQR: 1.26-2.02)上升到3.19 ng/mL (IQR: 2.71-5.12),同时c肽指数显著升高。ARNI给药后,免疫反应性胰岛素水平几乎没有变化,但免疫反应性胰岛素与CPR的比值显著下降,从3.3 (IQR: 2.5-3.9)降至1.6 (IQR: 1.3-1.9)。血清CPR水平的升高归因于CPR降解的抑制,而不是内源性胰岛素分泌的增加,因为空腹血糖水平保持不变。这些发现表明,在使用血清CPR水平评估ARNI治疗患者的内源性胰岛素分泌时需要谨慎,ARNI越来越多地用于心力衰竭和高血压。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of angiotensin receptor neprilysin inhibitor on serum C-peptide levels in patients with type 2 diabetes.

Sacubitril/valsartan, an angiotensin receptor neprilysin inhibitor (ARNI), is becoming more common in the treatment of heart failure and hypertension. Neprilysin is highly expressed in the renal tubules, and reports have shown increases in urinary C-peptide reactivity (CPR) levels after administration of ARNI. However, the effect of ARNI on serum CPR levels, a critical marker of insulin secretion in diabetes, remains underexplored. We evaluated the effect of ARNI on serum CPR levels in patients with type 2 diabetes and its impact on the assessment of endogenous insulin secretion. We retrospectively investigated the medical records of patients with type 2 diabetes at two hospitals, where fasting plasma glucose and serum CPR levels were measured before and after administration of ARNI. All eleven patients (five males, six females) who met the criteria showed an increase in median fasting serum CPR levels following ARNI administration. The levels rose from a median of 1.78 ng/mL (IQR: 1.26-2.02) to 3.19 ng/mL (IQR: 2.71-5.12), accompanied by significant increases in the C-peptide index. Immunoreactive insulin levels barely changed after ARNI administration, but the ratio of immunoreactive insulin to CPR decreased significantly, from 3.3 (IQR: 2.5-3.9) to 1.6 (IQR: 1.3-1.9). The increase in serum CPR levels is attributed to inhibition of CPR degradation rather than an increase in endogenous insulin secretion, as fasting blood glucose levels remained unchanged. These findings suggest the need for caution when using serum CPR levels to evaluate endogenous insulin secretion in patients treated with an ARNI, which are increasingly being prescribed for heart failure and hypertension.

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来源期刊
Diabetology International
Diabetology International ENDOCRINOLOGY & METABOLISM-
CiteScore
3.90
自引率
4.50%
发文量
42
期刊介绍: Diabetology International, the official journal of the Japan Diabetes Society, publishes original research articles about experimental research and clinical studies in diabetes and related areas. The journal also presents editorials, reviews, commentaries, reports of expert committees, and case reports on any aspect of diabetes. Diabetology International welcomes submissions from researchers, clinicians, and health professionals throughout the world who are interested in research, treatment, and care of patients with diabetes. All manuscripts are peer-reviewed to assure that high-quality information in the field of diabetes is made available to readers. Manuscripts are reviewed with due respect for the author''s confidentiality. At the same time, reviewers also have rights to confidentiality, which are respected by the editors. The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.
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