頁籤選單縮合
題 名 | 腸泌素在第二型糖尿病治療的角色=The Role of Incretin-Based Therapy in Type 2 Diabetes |
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作 者 | 呂金盈; | 書刊名 | 內科學誌 |
卷 期 | 22:6 2011.12[民100.12] |
頁 次 | 頁401-408 |
分類號 | 418.271 |
關鍵詞 | 腸泌素; 昇糖素類似胜肽; 雙基胜肽酶-4; 第二型糖尿病; Incretin; Glucagon-like peptide 1; GLP-1; Dipeptidyl peptidase 4; DPP-4; |
語 文 | 中文(Chinese) |
中文摘要 | 人體內最主要的腸泌素 (incretin)— 昇糖素類似胜肽 (glucagon-like peptide 1, 簡稱(GLP-1),是由遠端迴腸 (distal ileum) 及部分大腸 (colon) 所分泌的腸道荷爾蒙。食物會刺激GLP-1 由腸道分泌,進而根據血中葡萄糖濃度的上升程度,促進胰臟貝它細胞 (β cells) 之胰島素 (insulin) 分泌,抑制胰臟阿爾發細胞(α cells) 之昇糖素 (glucagon) 的分泌,以調節降低血中葡萄糖濃度。由於GLP-1 的作用依賴血中葡萄糖濃度而定,因此很少會引起低血糖的副 作用。GLP-1 也會抑制屬於周邊器官組織之胃部的排空(gastric emptying),並且促使屬於中樞神經之下視丘產生飽足感 (satiety sensation),造成抑制食慾及控制體重的效果。內生性的GLP-1 在人體會立刻被雙基胜肽酶-4 (dipeptidyl peptidase 4,簡稱DPP-4) 分解,轉變為不具生物學活性的代謝產物。利用腸泌素治療糖尿病,目前有兩種方式可以提升第二型糖尿病患者體內的腸泌素作用 (incretin action):其一為施打不會被DPP-4 所分解的腸泌素類似物 (incretin mimetics);其二為口服小分子的DPP-4 抑制劑 (DPP-4 inhibitor)。本文將探討腸泌素在第二型糖尿病治療的生物學背景以及其應用。 |
英文摘要 | One of the major incretins in humans, glucagon-like peptide 1 (GLP-1), is a glucose-lowering, intestinalderived hormone secreted from distal ileum and part of the colon. Food intake stimulates GLP-1 secretion, which in turn increases insulin secretion from pancreatic β cells, and suppresses glucagon secretion from pancreatic α cells. Because GLP-1 stimulates insulin secretion and inhibits glucagon secretion in a blood glucose-dependent manner, it rarely causes hypoglycemia. GLP-1 also increases central sensation of satiety and delays peripheral gastric emptying, thus has an anti-appetite and weight reduction effect. Once secreted, GLP-1 is rapidly degraded by dipeptidyl peptidase-4 (DPP-4) to form biologically inactive metabolites. Two strategies are applied to increase incretin action in type 2 diabetic patients, administration of injectable GLP-1 mimetics that are DPP-4 resistant and thus longer-acting, or of small molecule DPP-4 inhibitors to inhibit DPP-4 degradation of endogenous GLP-1 via oral route. In this review, incretin biology and the potential clinical use of incretin-based therapy in type 2 diabetes mellitus will be discussed. |
本系統中英文摘要資訊取自各篇刊載內容。