内分泌
词汇介绍
拓展阅读
解析
Sitagliptin
释 义 西格列汀(糖尿病类治疗药物名称)
例 句 Conclusion The sitagliptin can improve the insulin resistance situation in type 2 diabetes patients. 结论西格列汀可改善2型糖尿病患者胰岛素抵抗水平。
概述
概述
西格列汀是一种口服药物,可降低2型糖尿病患者的血糖水平。西格列汀被认为是除饮食和运动降糖以外的辅助手段。西格列汀不宜用于1型糖尿病患者或用于治疗糖尿病酮症酸中毒,因为在这些情况下无效。西格列汀尚未在有胰腺炎史的患者中研究,尚不清楚有胰腺炎病史的患者在使用西格列汀时是否有增加罹患胰腺炎的风险。
不良反应
①上市后已有急性胰腺炎的报道,包括致命性和非致命性出血性或坏死性胰腺炎。如果怀疑是胰腺炎,请立即停用西格列汀。
②上市后有急性肾功能衰竭的报告,对于中度或重度肾功能不全的患者以及ESRD患者,建议调整剂量。建议在开始西格列汀治疗之前和之后定期评估肾功能。
③将西格列汀添加到胰岛素促分泌剂(例如磺酰脲)或胰岛素治疗中时,发生低血糖的风险增加。考虑降低磺酰脲或胰岛素的剂量以降低低血糖的风险。
④上市后的报告显示,接受西格列汀治疗的患者出现严重的过敏和超敏反应,例如过敏反应,血管性水肿和剥落性皮肤病(包括史蒂文斯-约翰逊综合征)。在这种情况下,应立即停止西格列汀治疗,评估其他潜在原因,进行适当的监测和治疗,并开始糖尿病的替代治疗。没有临床研究确定西格列汀或任何其他抗糖尿病药物可降低大血管风险的确凿证据。
⑤最常见的副作用是:上呼吸道感染;头疼;
⑥其他重要副作用包括:腹痛;恶心和腹泻。
注意事项
告诉所有医疗保健提供者您正在服用西格列汀;如果血糖过低,请勿开车。按照医生的指示检查血糖;按照医生的指示定期检查相关指标;遵循医生的饮食和锻炼计划;在发烧,感染,受伤或手术的压力下,控制血糖可能会变得更加困难。体育锻炼或运动水平的变化以及饮食的变化也可能会影响您的血糖,这些情况应告知医师;这种药物会引起一种叫做大疱性类天疱疮的皮肤反应,有时,人们不得不去医院,如果您有水泡或皮肤开始破裂,请立即致电医生;服用这种药物的人可能会发生心力衰竭,因此需要告诉医生您是否曾经有过心力衰竭或肾脏问题,如果您感到非常疲倦,呼吸急促,体重增加过多或手臂或腿肿胀,请立即致电医生;西格列汀可引起肾脏问题,有时,肾脏问题可能需要在医院治疗,也可能需要透析,如有疑问,请咨询医生;如果年满65岁,请谨慎使用西格列汀,因为可能会有更多的副作用;告诉医生您是否怀孕,计划怀孕或正在哺乳,服用此药需要谈论对您和婴儿的好处和风险。
Sitagliptin decreases visceral fat and blood glucoses in women with polycystic ovarian syndrome 复制标题
西格列汀降低多囊卵巢综合征女性内脏脂肪和血液葡萄糖
发表时间:2019-09-15
影响指数:5.6
作者: Jessica K Devin
期刊:J Clin Endocrinol Metab
Growth hormone (GH) is secreted in a pulsatile fashion from the pituitary gland and exerts its effects either directly, via activation of the GH receptor, or indirectly, through hepatic insulin-like growth factor-1 (IGF-1). In adults, GH has important effects on the vasculature and body composition. GH increases endothelium-dependent vasodilator function and reduces inflammation. We have previously shown that patients with low GH have impaired conduit artery vasodilator function along with decreased tissue-type plasminogen activator (tPA) activity and a defective fibrinolytic response to venous occlusion. Others have corroborated these findings and further demonstrated that these vascular indices improve with GH replacement therapy. GH also has anabolic and lipolytic effects. Conversely, GH secretion is reduced in obesity and particularly in individuals with visceral adiposity. Women with increased visceral adipose tissue (VAT) demonstrate a four-fold reduction in mean GH levels as compared to those without. Normalization of GH secretion in patients with diminished GH affords one potential mechanism to address simultaneously both VAT and cardiovascular risk. Unfortunately, therapy with recombinant GH does not restore pulsatile secretion, is not subject to physiologic negative feedback by IGF-1, and is limited by hyperglycemia. We propose that an alternative strategy to enhance endogenous GH secretion in humans is to inhibit the degradation of endogenous GH releasing hormone (GHRH) by the dipeptidyl peptidase-4 (DPP4) enzyme. GHRH is the primary stimulus for pituitary GH secretion and determines GH pulsatility. Endogenous GHRH has a half-life of six minutes as it is degraded and inactivated by DPP4. Sitagliptin was the first oral DPP4 inhibitor approved by the US Food and Drug Administration for the management of hyperglycemia in patients with type 2 diabetes mellitus. Sitagliptin improves post-prandial hyperglycemia in a glucose-dependent manner by decreasing the degradation of the incretin hormone, glucagon-like peptide-1 (GLP1), and can therefore be safely given to patients without diabetes mellitus. We recently found that acute DPP4 inhibition with sitagliptin enhances stimulated GH secretion and free IGF-1 levels in healthy, lean women. Moreover, while vasodilation and tPA activity levels increased in both men and women during stimulated GH secretion, women demonstrated an enhanced vascular response to increased GH. The effect of chronic DPP4 inhibition on pulsatile GH secretion in individuals with low GH levels has not been studied.
译文