利昔那肽对2型糖尿病患者胃排空的影响-与餐后血糖的关系

Martin Lorenz , Claudia Pfeiffer , Axel Steinsträßer , Reinhard H.A. Becker , Hartmut Rütten , Peter Ruus , Michael Horowitz
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引用次数: 129

摘要

目的探讨利昔那肽(lixisenatide)对2型糖尿病(T2DM)患者餐后血糖(PPG)和胃排空的影响及其相互关系。利昔那肽是一种新的每日一次(QD)胰高血糖素样肽-1受体激动剂。方法数据来自随机、双盲、安慰剂对照、平行组研究,接受≤2种口服降糖药治疗的T2DM患者,疗程为28天。利昔那肽皮下注射,剂量逐渐递增(5 ~ 20 μg),每5天增加2.5 μg。测定三顿标准化餐(早餐、午餐和晚餐)前后的血糖。在基线(第1天)和第28天,通过13c -辛酸呼吸试验测定标准化早餐的胃排空。结果21例和22例患者随机分为利昔那肽20 μg QD组和安慰剂组。使用利昔那肽20 μg QD,与安慰剂相比,早餐后PPG降低(p <0.0001),午餐(p <0.001)和晚餐(p <0.05)。因此,利昔那肽20 μg在早晨给药表现出全天对血糖的药效学影响。利昔那肽20 μg QD组胃排空时间(50%排空时间)较基线显著增加,而安慰剂组则没有(与基线的变化±SD:安慰剂组为- 24.1±133.1 min,利昔那肽组为211.5±278.5 min;p & lt;0.01)。利昔那肽20 μg QD后,早餐后PPG曲线下面积与胃排空呈负相关(n = 17, r2 = 0.51, p <0.05),但安慰剂组没有。结论:在本研究中,利昔那肽在20 μg QD剂量下可降低T2DM患者餐后血糖漂移,可能是由于胃排空持续减慢。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of lixisenatide once daily on gastric emptying in type 2 diabetes — Relationship to postprandial glycemia

Objectives

To determine the effects of lixisenatide, a new once-daily (QD) glucagon-like peptide-1 receptor agonist, on postprandial glucose (PPG) and gastric emptying, and the relationship between these effects in patients with type 2 diabetes mellitus (T2DM).

Methods

Data were obtained from a randomized, double-blind, placebo-controlled, parallel-group study with treatment duration of 28 days in patients with T2DM receiving ≤ 2 oral antidiabetic drugs. Lixisenatide was injected subcutaneously using an ascending dose range (5–20 μg) increased every fifth day in increments of 2.5 μg. Blood glucose was determined before and after three standardized meals (breakfast, lunch, and dinner). Gastric emptying of the standardized breakfast was determined by a 13C-octanoic acid breath test at baseline (Day−1) and at Day 28.

Results

A total of 21 and 22 patients were randomized to lixisenatide 20 μg QD and placebo, respectively. With lixisenatide 20 μg QD, there was a reduction in PPG when compared with placebo after breakfast (p < 0.0001), lunch (p < 0.001) and dinner (p < 0.05). Hence, lixisenatide 20 μg administered in the morning exhibited a pharmacodynamic effect on blood glucose throughout the day. Gastric emptying (50% emptying time) increased substantially from baseline with lixisenatide 20 μg QD, but not with placebo (change from baseline ± SD: − 24.1 ± 133.1 min for placebo and 211.5 ± 278.5 min for lixisenatide; p < 0.01). There was an inverse relationship between PPG area under the curve after breakfast and gastric emptying with lixisenatide 20 μg QD (n = 17, r2 = 0.51, p < 0.05), but not with placebo.

Conclusions

In this study, lixisenatide at a dose of 20 μg QD reduced postprandial glycemic excursions in patients with T2DM, possibly as a result of sustained slowing of gastric emptying.

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来源期刊
Regulatory Peptides
Regulatory Peptides 医学-内分泌学与代谢
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审稿时长
2 months
期刊介绍: Regulatory Peptides provides a medium for the rapid publication of interdisciplinary studies on the physiology and pathology of peptides of the gut, endocrine and nervous systems which regulate cell or tissue function. Articles emphasizing these objectives may be based on either fundamental or clinical observations obtained through the disciplines of morphology, cytochemistry, biochemistry, physiology, pathology, pharmacology or psychology.
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