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JCEM:胰高血糖素样肽-1受体激动剂对下丘脑-垂体-肾上腺轴的影响

2018-10-02 xing.T MedSci原创

由此可见,该研究的结果表明长期给予GLP-1 RA不会激活HPA轴,尤其是每周一次1.5 mg医学批准剂量的dulaglutide。

动物和人类研究的最新发现表明胰高血糖素样肽-1(GLP-1)受体激动剂(RA)通过激活下丘脑-垂体-肾上腺(HPA)轴来调节应激反应,这可能具有相关的临床意义。近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,该研究旨在调查GLP-1 RA治疗与安慰剂相比对健康志愿者HPA轴活性的影响。

这项双盲、随机、交叉研究以巴塞尔大学医院为基础,参与者为20名健康志愿者。受试者每周一次皮下给予Dulaglutide(Trulicity®)1.5mg和安慰剂(0.9%氯化钠),持续三周。主要观察指标为24h尿中游离皮质醇、血清和唾液皮质醇的昼夜节律、1mg地塞米松抑制试验后的皮质醇水平以及促肾上腺皮质激素(ACTH)刺激前后的皮质醇水平。

与安慰剂(188nmol/l[133-338],p=0.131)相比,dulaglutide组(中位数[IQR]为240nmol/l[164-324])尿中游离皮质醇水平相似。两组血清和唾液皮质醇的昼夜节律与地塞米松刺激后皮质醇水平相当(dulaglutide为28nmol/l [22-47.5] vs. 安慰剂为26.5[15.8-45.5],p=0.4)。dulaglutide和安慰剂治疗参与者的血清皮质醇水平在ACTH刺激前分别为522nmol/l [388-710]和530nmol/l [394-747],p=0.6,在ACTH刺激后分别为658nmol/l [604-810]和636nmol/l[512-910],p=0.87。

由此可见,该研究的结果表明长期给予GLP-1 RA不会激活HPA轴,尤其是每周一次1.5 mg医学批准剂量的dulaglutide。

原始出处:


Anthony J Swerdlow,et al. Effects of glucagon-like peptide-1 receptor agonists on hypothalamic-pituitary-adrenal axis in healthy volunteers.J Clin Endocrinol Metab. 2018. https://doi.org/10.1210/jc.2018-01420

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    2019-06-22 smallant2015
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objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20119, encryptionId=c8ba20119d1, topicName=下丘脑)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Thu Oct 04 02:56:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457629, encodeId=aa77145e6297d, content=<a href='/topic/show?id=72148400568' target=_blank style='color:#2F92EE;'>#胰高血糖素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84005, encryptionId=72148400568, topicName=胰高血糖素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b38f5964248, createdName=sjzlzc009, createdTime=Thu Oct 04 02:56:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1458261, encodeId=f7cb14582619a, content=<a href='/topic/show?id=beff41500cf' target=_blank style='color:#2F92EE;'>#垂体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41500, encryptionId=beff41500cf, topicName=垂体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Thu Oct 04 02:56:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1558303, encodeId=8c4e155830359, content=<a href='/topic/show?id=c8a7208e8a8' target=_blank style='color:#2F92EE;'>#丘脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20878, encryptionId=c8a7208e8a8, topicName=丘脑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb8814960000, createdName=xlwang2696, createdTime=Thu Oct 04 02:56:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564312, encodeId=51791564312f7, content=<a href='/topic/show?id=c8a7208e8a8' target=_blank style='color:#2F92EE;'>#丘脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20878, encryptionId=c8a7208e8a8, topicName=丘脑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb8814960000, createdName=xlwang2696, createdTime=Thu Oct 04 02:56:00 CST 2018, time=2018-10-04, status=1, ipAttribution=)]
    2019-08-04 achengzhao
  5. [GetPortalCommentsPageByObjectIdResponse(id=1895155, encodeId=ab181895155bf, content=<a href='/topic/show?id=ce478241e0b' target=_blank style='color:#2F92EE;'>#肾上腺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82417, encryptionId=ce478241e0b, topicName=肾上腺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8dba135, createdName=xuyong523, createdTime=Sat Oct 13 00:56:00 CST 2018, time=2018-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1694265, encodeId=445616942657a, content=<a href='/topic/show?id=f3ad840081f' target=_blank style='color:#2F92EE;'>#胰高血糖素样肽-1#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84008, encryptionId=f3ad840081f, topicName=胰高血糖素样肽-1)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9c5929589014, createdName=liuquanmn, createdTime=Thu Nov 01 13:56:00 CST 2018, time=2018-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1777832, encodeId=83491e7783221, content=<a href='/topic/show?id=eb9610265ed' target=_blank style='color:#2F92EE;'>#JCEM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10265, encryptionId=eb9610265ed, topicName=JCEM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2a4439169927, createdName=smallant2015, createdTime=Sat Jun 22 05:56:00 CST 2019, time=2019-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2063214, encodeId=7fea2063214cb, content=<a href='/topic/show?id=14fb10264d7' target=_blank style='color:#2F92EE;'>#JCE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, 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objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20119, encryptionId=c8ba20119d1, topicName=下丘脑)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Thu Oct 04 02:56:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457629, encodeId=aa77145e6297d, content=<a href='/topic/show?id=72148400568' target=_blank style='color:#2F92EE;'>#胰高血糖素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84005, encryptionId=72148400568, topicName=胰高血糖素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b38f5964248, createdName=sjzlzc009, createdTime=Thu Oct 04 02:56:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1458261, encodeId=f7cb14582619a, content=<a href='/topic/show?id=beff41500cf' target=_blank style='color:#2F92EE;'>#垂体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41500, encryptionId=beff41500cf, topicName=垂体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Thu Oct 04 02:56:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1558303, encodeId=8c4e155830359, content=<a href='/topic/show?id=c8a7208e8a8' target=_blank style='color:#2F92EE;'>#丘脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20878, encryptionId=c8a7208e8a8, topicName=丘脑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb8814960000, createdName=xlwang2696, createdTime=Thu Oct 04 02:56:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564312, encodeId=51791564312f7, content=<a href='/topic/show?id=c8a7208e8a8' target=_blank style='color:#2F92EE;'>#丘脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20878, encryptionId=c8a7208e8a8, topicName=丘脑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb8814960000, createdName=xlwang2696, createdTime=Thu Oct 04 02:56:00 CST 2018, time=2018-10-04, status=1, ipAttribution=)]
    2018-10-04 hbwxf
  6. [GetPortalCommentsPageByObjectIdResponse(id=1895155, encodeId=ab181895155bf, content=<a href='/topic/show?id=ce478241e0b' target=_blank style='color:#2F92EE;'>#肾上腺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82417, encryptionId=ce478241e0b, topicName=肾上腺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8dba135, createdName=xuyong523, createdTime=Sat Oct 13 00:56:00 CST 2018, time=2018-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1694265, encodeId=445616942657a, content=<a href='/topic/show?id=f3ad840081f' target=_blank style='color:#2F92EE;'>#胰高血糖素样肽-1#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84008, encryptionId=f3ad840081f, topicName=胰高血糖素样肽-1)], attachment=null, authenticateStatus=null, createdAvatar=null, 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564312, encodeId=51791564312f7, content=<a href='/topic/show?id=c8a7208e8a8' target=_blank style='color:#2F92EE;'>#丘脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20878, encryptionId=c8a7208e8a8, topicName=丘脑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fb8814960000, createdName=xlwang2696, createdTime=Thu Oct 04 02:56:00 CST 2018, time=2018-10-04, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1895155, encodeId=ab181895155bf, content=<a href='/topic/show?id=ce478241e0b' target=_blank style='color:#2F92EE;'>#肾上腺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82417, encryptionId=ce478241e0b, topicName=肾上腺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8dba135, createdName=xuyong523, createdTime=Sat Oct 13 00:56:00 CST 2018, time=2018-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1694265, encodeId=445616942657a, content=<a href='/topic/show?id=f3ad840081f' target=_blank style='color:#2F92EE;'>#胰高血糖素样肽-1#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84008, encryptionId=f3ad840081f, topicName=胰高血糖素样肽-1)], attachment=null, authenticateStatus=null, createdAvatar=null, 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    2018-10-04 xlwang2696
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    2018-10-04 xlwang2696

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Diabetes Care: 在糖尿病患者中发现新生物标记物与心血管疾病有关

通常认为,糖尿病患者可以通过严格控制血糖水平来降低CVD风险。但在2008年,一项名为ACCORD(Action to Control Cardiovascular Risk in Diabetes, “在糖尿病患者中控制心血管风险行动”)的研究发现,在CVD高风险的糖尿病患者中,那些严格控制血糖的患者发生致死性心脏病的风险竟然高过并未严格控制血糖的患者。最近,波士顿Joslin Diabetes

Diabetes:GLP-1与胃饥饿素协同调节葡萄糖耐受

新出现的证据表明胃饥饿素对预防饥饿诱导的低血糖具有重要意义。可效应可能是通过抑制葡萄糖刺激的胰岛素分泌以及降低胰岛素敏感性介导的。但是,在进食过程中服用饥饿素也可刺激释放胰高血糖素样肽(GLP-1)——在营养配置过程中发挥重要作用的一种肠促胰岛素。Laura C. Page等研究人员开展研究对饥饿素与GLP-1对混合营养餐后的唐耐受参数的相互作用进行评估。其共招募了15位健康成年人(男女都有)。1

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