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首页> 外文期刊>Cell metabolism >Postprandial Hypoglycemia in Patients after Gastric Bypass Surgery Is Mediated by Glucose-Induced IL-1 beta
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Postprandial Hypoglycemia in Patients after Gastric Bypass Surgery Is Mediated by Glucose-Induced IL-1 beta

机译：胃旁路手术患者患者的后催化剂由葡萄糖诱导的IL-1β介导

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Postprandial hypoglycemia is a disabling complication of the treatment of obesity by gastric bypass surgery. So far, no therapy exists, and the underlying mechanisms remain unclear. Here, we hypothesized that glucose-induced IL-1 beta leads to an exaggerated insulin response in this condition. Therefore, we conducted a placebo-controlled, randomized, double-blind, crossover study with the SGLT2-inhibitor empagliflozin and the 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, pval(likelihood 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, pval(LRT) = 0.048). Moreover, analysis of monocytes ex vivo revealed a hyper-reactive inflammatory state that has features of an exaggerated response to a meal. Our study proposes a role for glucose-induced IL-1 beta in postprandial hypoglycemia after gastric bypass surgery and suggests that SGLT2-inhibitors and IL-1 antagonism may improve this condition.
机译：后催化剂的低血糖是胃旁路手术治疗肥胖症的并发症。到目前为止，不存在治疗，潜在机制仍不清楚。在这里，我们假设葡萄糖诱导的IL-1β在这种情况下导致夸张的胰岛素反应。因此，我们进行了与SGLT2抑制剂Empagliflozin和IL-1受体拮抗剂Anakinra（Clinicaltrials.gov NCT03200782; N = 12）进行安慰剂控制，随机的双盲，交叉研究。两种药物减少后胰岛素释放和预防低血糖（需要救助葡萄糖的症状事件：安慰剂= 7/12，Empagliflozin = 2/12，PVAL（似然比试验）（LRT）= 0.013; Nadir血糖对于安慰剂= 2.4mmol / L，95％CI 2.18-2.62，Empagliflozin = 2.69mmol / L，95％CI 2.31-3.08和Anakinra = 2.99mmol / L，95％CI 2.43-3.55，PVAL（LRT）= 0.048 ）。此外，单核细胞exVivo的分析显示出一种具有夸大膳食反应的特征的超反应性炎症状态。我们的研究提出了在胃旁路手术后对餐后低血糖中的葡萄糖诱导的IL-1β中的作用，并表明SGLT2-抑制剂和IL-1拮抗剂可能改善这种情况。

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