Abstract
Visceral obesity and insulin resistance are regarded as risk factors for atherosclerosis.
Epidemiologic studies have demonstrated long-term anti-atherosclerotic effects with
administration of α-glucosidase inhibitors. α-Glucosidase inhibitors also have been reported to enhance glucagon-like peptide 1
(GLP-1) secretion. We compared the postprandial effects of a single administration
of miglitol and acarbose on glucose and lipid metabolism, on insulin requirement,
on GLP-1 secretion, and on inflammatory and endothelial markers in viscerally obese
subjects. Twenty-four viscerally obese subjects with relative insulin resistance participated
in this study. Subjects were given a single dose of miglitol (50 mg), acarbose (100
mg), or placebo blindly and randomly before a meal in a crossover design. The meal
loads after drug administration were tested 3 times within 2 weeks. We measured glucose,
insulin, lipids, lipoprotein lipase, interleukin 6, intracellular adhesion molecule
1, vascular cell adhesion molecule 1, and active GLP-1 at before and various minutes
after the meal. Single administration of both α-glucosidase inhibitors had several beneficial effects in improving postprandial hyperglycemia
and reducing postprandial insulin requirement approximately 25% of placebo without
adversely affecting lipid profiles. Although lipoprotein lipase levels within 2 hours
after the meal did not show differences among miglitol, acarbose, and placebo administrations,
miglitol significantly suppressed the increases in triglycerides, remnant-like particle
triglycerides, and remnant-like particle cholesterol compared to acarbose and placebo
in the early phase. Miglitol also significantly enhanced active GLP-1 secretion to
a greater extent than acarbose (P < .01) and placebo (P < .001), and significantly suppressed the postprandial increase in interleukin 6
compared to placebo (P < .01). The results point to the potential suitability of miglitol as an anti-atherosclerotic
effect in viscerally obese subjects, in preference to acarbose. Further studies are
needed to elucidate the long-term effects on enhanced GLP-1 secretion and anti-atherosclerosis.
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Article info
Publication history
Accepted:
April 22,
2008
Received:
February 6,
2008
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
