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GLP-1类似物与2型糖尿病及其慢性并发症的研究进展

Research Progress in GLP-1 Analogues with Type 2 Diabetes Mellitus and Its Chronic Complications

【作者】 聂佳

【导师】 刘宽芝;

【作者基本信息】 河北医科大学 , 内科学, 2009, 硕士

【摘要】 胰升糖素样肽1(glucagons-like peptide-1,GLP-1)是主要由肠道L细胞分泌的一种胃肠道激素,具有刺激胰岛β细胞葡萄糖介导的胰岛素分泌,抑制胰升糖素分泌,减少肝葡萄糖输出,延缓胃内容物排空,改善外周组织对胰岛素的敏感性,抑制食欲及摄食等作用,其可被二肽基肽酶Ⅳ(dipeptidy1 proteaseⅣ,DPP-Ⅳ)降解,半衰期极短,限制了其临床应用。GLP-1类似物克服了GLP-1 T1 /2短的缺点,DPP-Ⅳ抑制剂抑制GLP-1的降解,给糖尿病治疗带来新的契机。近来研究还发现,GLP-1类似物和DPP-Ⅳ抑制剂对循环系统及神经系统具有保护作用,加强这方面的研究可能会为临床上糖尿病及其相关心血管疾病、神经系统疾病的治疗带来新的希望。依克那肽(exenatide)作为首个获准的GLP-1类似物,目前已经进行了大量临床研究。本文就GLP-1类似物作用机制及其对2型糖尿病及其慢性并发症的治疗及应用前景作一综述。

【Abstract】 GLP-1 is an incretin hormone secreted from enteroendocrine L cells and pancreatic cells in response to ingested nutrients.physiological functions include increaseing insulin secretion from the pancreas in a glucose-dependent manner,decreaseing glucagon secretion from the pancreas,increaseing beta cells mass and insulin gene expression,inhibiting acid secretion and gastric emptying in the stomach,and decreasing food intake by increasing satiety.But it is rapidly inactivated by the enzyme dipeptidyl peptidaseⅣ(DPP-Ⅳ),which greatly limits its clinical application.GLP-1 analogs overcome the disadvantage of short T1/2 of GLP-1,and give the treatment for diabetes a new opportunity.DPP-Ⅳinhibitors inhibit the degradation of GLP-1.It has been demonstrated recently that GLP-1 analogues and DPP-Ⅳinhibitor play a protective role in the circulatory system and nervous system,These observations may subject to results of future studies translate into improved cardiovascular and neuval outcomes in this vulnerable patient population.Exenatide,as a first approved GLP-1 analogues,has conducted a large number of clinical trial.This article summarizes current concepts of GLP-1,s action and highlights the potential therapeutic utility for the treatment of Diabetes mellitus and its chronic complications.

  • 【分类号】R587.1
  • 【被引频次】1
  • 【下载频次】548
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