F Zheng1, X Yin, W Lu, J Zhou, H Yuan, H Li. 1. Department of Endocrinology, Sir Run Run Shaw Hospital Affiliated with School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Abstract
BACKGROUND: Recent studies highlight an important role of ghrelin in glucose homeostasis, while the association between ghrelin regulation and glucose fluctuation is unclear. AIM: We compared the effects of two postprandial hypoglycemic agents on ghrelin response and determined the contribution of ghrelin response to glucose stability in Type 2 diabetic (T2DM) patients. SUBJECTS AND METHODS: Forty newly- diagnosed T2DM patients were randomly allocated to receive nateglinide or acarbose for 4 weeks, with twenty body mass index (BMI)-matched normoglycemic subjects as controls. Mean glucose values and daily average glucose excursion were assessed using continuous glucose monitoring system. Serum ghrelin levels were determined by enzyme-linked immunosorbent assay. RESULTS: T2DM patients had similar fasting ghrelin levels (p=0.546), while their postprandial ghrelin suppressions at 30 min and 120 min were reduced as compared to BMI-matched normoglycemic controls (p<0.01). Both nateglinide and acarbose increased post-prandial ghrelin suppression at 120 min and reduced ghrelin area under the curve (AUCGHRL) (p<0.05), while only nateglinide increased postprandial ghrelin suppression at 30 min (p<0.01), which was positively correlated with the increased early-phase insulin secretion by 4 weeks of nateglinide therapy (r=0.48, p=0.05). The decrease in AUCGHRL was positively correlated with the decrease in daily average glucose excursion and mean glucose values either by 4 weeks of nateglinide or acarbose therapy (p<0.05). CONCLUSIONS: Both nateglinide and acarbose increase post-prandial ghrelin suppression. Improved ghrelin regulation is most likely to play a role in glucose stability in T2DM patients with nateglinide or acarbose therapy.
RCT Entities:
BACKGROUND: Recent studies highlight an important role of ghrelin in glucose homeostasis, while the association between ghrelin regulation and glucose fluctuation is unclear. AIM: We compared the effects of two postprandial hypoglycemic agents on ghrelin response and determined the contribution of ghrelin response to glucose stability in Type 2 diabetic (T2DM) patients. SUBJECTS AND METHODS: Forty newly- diagnosed T2DM patients were randomly allocated to receive nateglinide or acarbose for 4 weeks, with twenty body mass index (BMI)-matched normoglycemic subjects as controls. Mean glucose values and daily average glucose excursion were assessed using continuous glucose monitoring system. Serum ghrelin levels were determined by enzyme-linked immunosorbent assay. RESULTS: T2DM patients had similar fasting ghrelin levels (p=0.546), while their postprandial ghrelin suppressions at 30 min and 120 min were reduced as compared to BMI-matched normoglycemic controls (p<0.01). Both nateglinide and acarbose increased post-prandial ghrelin suppression at 120 min and reduced ghrelin area under the curve (AUCGHRL) (p<0.05), while only nateglinide increased postprandial ghrelin suppression at 30 min (p<0.01), which was positively correlated with the increased early-phase insulin secretion by 4 weeks of nateglinide therapy (r=0.48, p=0.05). The decrease in AUCGHRL was positively correlated with the decrease in daily average glucose excursion and mean glucose values either by 4 weeks of nateglinide or acarbose therapy (p<0.05). CONCLUSIONS: Both nateglinide and acarbose increase post-prandial ghrelin suppression. Improved ghrelin regulation is most likely to play a role in glucose stability in T2DM patients with nateglinide or acarbose therapy.
Authors: Mi K Kim; Ji H Suk; Min J Kwon; Hye S Chung; Chang S Yoon; Hye J Jun; Jung H Ko; Tae K Kim; Soon H Lee; Min K Oh; Byoung D Rhee; Jeong H Park Journal: Diabetes Res Clin Pract Date: 2011-03-03 Impact factor: 5.602
Authors: Natalia Rudovich; Matthias Möhlig; Bärbel Otto; Olga Pivovarova; Joachim Spranger; Martin O Weickert; Andreas F H Pfeiffer Journal: Diabetes Technol Ther Date: 2010-01 Impact factor: 6.118