糖尿病五架马车.ppt

* 事实上，UKPDS研究早已证实血糖控制更好的磺脲类药物组?细胞分泌功能保存更好。比较治疗6年后饮食控制组、二甲双胍组和磺脲类药物治疗组，磺脲类药物治疗组的?细胞分泌功能保存最好。 * Rosiglitazone Restores ?-Cell Insulin Content in Pancreatic Islets in db/db Mice In this study, db/db mice (genetically diabetic) were treated for 28 days with RSG, glyburide, or metformin. Untreated db/db mice and lean controls were also studied. These slides show pancreatic islet beta-cells from 5 db/db mice and from 1 untreated lean-control mouse. On the far left of the top row is a cell from an untreated db/db animal, compared with an RSG-treated animal on the left panel of the bottom row. Note the increased insulin content in the cell of the mouse treated with RSG. Also on the top row are cells from db/db mice treated with an SU or metformin, showing similar loss of insulin content to the untreated db/db animal. Note the resemblance in the RSG-treated animal cell to the cell on the bottom right, which is from a lean control animal without insulin resistance. Rosiglitazone reduced hyperglycemia and preserved plasma and beta-cell insulin in the db/db mouse, while neither metformin nor the SU affected insulin content. Rosiglitazone was the only agent studied in this animal model that was able to demonstrate such a robust preservation of beta-cells and insulin production. Quantitative image analysis of pancreatic sections immunostained for insulin revealed that islet area was increased by 50%-65% (p0.05) after 6 or 10 days treatment with rosiglitazone. Islet density (islets/mm2 pancreas) was increased 2-fold after 3 days and was characterized by the appearance of many small clusters of cells intensely stained for insulin, suggesting enhanced islet neogenesis. The effects of RSG on islet hormone and mRNA expression profiles after correction of hyperglycemia were also determined. Islet insulin of control db/db mice was reduced by 70% relative to non-diabetic lean littermates. RSG increased insulin content 3.2-fold. RSG-induced expansion of islet area, density and hormo