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葡萄糖诱导的IL-1β介导胃旁路手术患者的餐后低血糖
作者:小柯机器人 发布时间:2020/3/24 17:48:47

瑞士巴塞尔大学Marc Y. Donath研究团队近日发现,葡萄糖诱导的IL-1β介导胃旁路手术患者的餐后低血糖。相关论文于2020年3月19日在线发表在《细胞—代谢》杂志上。

据研究人员介绍,餐后低血糖是胃旁路手术治疗肥胖症后的并发症。到目前为止,尚无治疗方法,且其潜在机制仍不清楚。
 
研究人员猜测在这种情况下葡萄糖诱导的IL-1β会导致胰岛素反应过度。因此,研究人员使用SGLT2抑制剂恩格列净和IL-1受体拮抗剂阿那白滞素进行了安慰剂对照、随机、双盲、交叉研究(Clinicaltrials.gov编号NCT03200782;n = 12)。
 
两种药物均能减少餐后胰岛素释放并预防低血糖症(症状事件需要葡萄糖补充:安慰剂=7/12,恩格列净=2/12,和阿那白滞素=2/12,pval LRT=0.013;安慰剂最低血糖=2.4 mmol/L,95%CI 2.18–2.62,恩格列净=2.69 mmol / L,95%CI 2.31–3.08,以及阿那白滞素= 2.99 mmol / L,95%CI 2.43–3.55,pval LRT = 0.048)。
 
此外,对离体单核细胞的分析显示出反应过度的炎症状态,即具有对膳食过度反应的特征。
 
这项研究揭示了在胃旁路手术后,葡萄糖诱导的IL-1β在餐后低血糖中的作用,并表明SGLT2抑制剂和IL-1拮抗作用可能改善这种情况。
 
附:英文原文

Title: Postprandial Hypoglycemia in Patients after Gastric Bypass Surgery Is Mediated by Glucose-Induced IL-1β

Author: Matthias Hepprich, Sophia J. Wiedemann, Benjamin L. Schelker, Beckey Trinh, Alessandra Strkle, Marco Geigges, Jordan Lliger, Marianne Bni-Schnetzler, Gottfried Rudofsky, Marc Y. Donath

Issue&Volume: 2020-03-19

Abstract: Postprandial hypoglycemia is a disabling complication of the treatment of obesityby gastric bypass surgery. So far, no therapy exists, and the underlying mechanismsremain unclear. Here, we hypothesized that glucose-induced IL-1β leads to an exaggeratedinsulin response in this condition. Therefore, we conducted a placebo-controlled,randomized, double-blind, crossover study with the SGLT2-inhibitor empagliflozin andthe IL-1 receptor antagonist anakinra (clinicaltrials.gov NCT03200782; n = 12). Both drugs reduced postprandial insulin release and prevented hypoglycemia(symptomatic events requiring rescue glucose: placebo = 7/12, empagliflozin = 2/12,and anakinra = 2/12, pvallikelihood ratio test (LRT) = 0.013; nadir blood glucose for placebo = 2.4 mmol/L, 95% CI 2.18–2.62, empagliflozin =2.69 mmol/L, 95% CI 2.31–3.08, and anakinra = 2.99 mmol/L, 95% CI 2.43–3.55, pvalLRT = 0.048). Moreover, analysis of monocytes ex vivo revealed a hyper-reactive inflammatory state that has features of an exaggeratedresponse to a meal. Our study proposes a role for glucose-induced IL-1β in postprandialhypoglycemia after gastric bypass surgery and suggests that SGLT2-inhibitors and IL-1antagonism may improve this condition.

DOI: 10.1016/j.cmet.2020.02.013

Source: https://www.cell.com/cell-metabolism/fulltext/S1550-4131(20)30072-3

期刊信息

Cell Metabolism:《细胞—代谢》,创刊于2005年。隶属于细胞出版社,最新IF:22.415
官方网址:https://www.cell.com/cell-metabolism/home
投稿链接:https://www.editorialmanager.com/cell-metabolism/default.aspx