瑞士巴塞尔大学Marc Y. Donath研究团队近日发现，葡萄糖诱导的IL-1β介导胃旁路手术患者的餐后低血糖。相关论文于2020年3月19日在线发表在《细胞—代谢》杂志上。
Title: Postprandial Hypoglycemia in Patients after Gastric Bypass Surgery Is Mediated by Glucose-Induced IL-1β
Author: Matthias Hepprich, Sophia J. Wiedemann, Benjamin L. Schelker, Beckey Trinh, Alessandra Strkle, Marco Geigges, Jordan Lliger, Marianne Bni-Schnetzler, Gottfried Rudofsky, Marc Y. Donath
Abstract: Postprandial hypoglycemia is a disabling complication of the treatment of obesityby gastric bypass surgery. So far, no therapy exists, and the underlying mechanismsremain unclear. Here, we hypothesized that glucose-induced IL-1β leads to an exaggeratedinsulin response in this condition. Therefore, we conducted a placebo-controlled,randomized, double-blind, crossover study with the SGLT2-inhibitor empagliflozin andthe 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, pvallikelihood 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, pvalLRT = 0.048). Moreover, analysis of monocytes ex vivo revealed a hyper-reactive inflammatory state that has features of an exaggeratedresponse to a meal. Our study proposes a role for glucose-induced IL-1β in postprandialhypoglycemia after gastric bypass surgery and suggests that SGLT2-inhibitors and IL-1antagonism may improve this condition.