Subscribe to RSS
DOI: 10.1055/s-0028-1119407
© Georg Thieme Verlag KG Stuttgart · New York
Effect of Acarbose on Postmeal Mononuclear Blood Cell Response in Patients with Early Type 2 Diabetes: The AI(I)DA Study
Publication History
received 24.09.2008
accepted 09.12.2008
Publication Date:
12 February 2009 (online)
![](https://www.thieme-connect.de/media/hmr/200902/lookinside/thumbnails/10.1055-s-0028-1119407-1.jpg)
Abstract
So far little is known about how the antidiabetic drugs acting at the level of gastrointestinal mucosa may affect immune and cellular response to food intake. The following study investigated the association between acarbose treatment and postprandial metabolism, immune- and inflammatory activity in patients with early type 2 diabetes: The Acarbose action on low grade Inflammation and Immune response in type 2 Diabetes on Atherosclerosis risk (AIIDA) study. Middle-aged patients (n=87) with early type 2 diabetes (2 h-plasma-glucose ≥11.1 mmol/l and/or HbA1c ≥6.5%) and sub-clinical inflammation (leucocytes ≥6.2 GPt/l and/or hsCRP ≥1.0 mg/l) underwent a mixed meal load (527 kcal). Metabolic parameters and markers of subclinical inflammation were measured at fasting (0′), 2 h-postprandial (2-hpp) and 4-hpp before and after 20 weeks of treatment with acarbose or placebo. Leukocytes and lymphocytes excursion after 20 weeks of treatment was significantly reduced with acarbose 4 h after testmeal [GPt/l] (7.5 vs. 7; p<0.05; and 2.29 vs. 2.14; p<0.05, respectively). Acarbose had only marginal effects on pp glucose, FFA, triglycerides, and insulin excursion. Biomarkers of inflammation (hsCRP, MBL, and PAI1) were not affected by acarbose. Multivariate analysis reveals only baseline leukocytes and of acarbose as independent determinant of 4-h leucocytes excursion. Postprandial metabolic and inflammatory parameters were strongly interrelated. These results suggest pleiotropic effects of acarbose, which may contribute to its vasoprotective potentials.
Key words
diabetes mellitus type 2 - acarbose - postmeal leukocyte excursion - postmeal adipokine excursion
References
- 1 Guideline for management of postmeal glucose. International Diabetes Federation. Belgium 2007 http://www.idf.org
- 2 Puls W, Keup U, Krause HP, Thomas G, Hoffmeister F. Glucosidase inhibition. A new approach to the treatment of diabetes, obesity and hyperlipoproteinemia. Naturwissenschaften. 1977; 64 536-537
- 3 Oostrom AJ Van, Sijmonsma TP, Rabelink TJ, Asbeck BS Van, Cabezas MC. Postprandial leukocyte increase in healthy subjects. Metabolism. 2003; 52 199-202
- 4 Dworacka M, Winiarska H, Borowska M, Abramczyk M, Bobkiewicz-Kozlowska T, Dworacki G. Pro-atherogenic alterations in T-lymphocyte subpopulations related to acute hyperglycaemia in type 2 diabetic patients. Circ J. 2007; 71 962-967
- 5 Bouter KP, Meyling FH, Hoekstra JB, Masurel N, Erkelens DW, Diepresloot RJ. Influence of blood glucose levels on periheral lymphocytes in patients with diabetes mellitus. Diabetes Res. 1992; 19 77-80
- 6 Nilsson J, Bengtsson E, Fredrikson GN, Björkbacka H. Inflammation and immunity in diabetic vascular complications. Curr Opin Lipidol. 2008; 19 519-524
- 7 Qualmann C, Nauck MA, Holst JJ, Orskov C, Creutzfeldt W. Glucagon-like peptide 1 (7–36 amide) secretion in response to luminal sucrose from the upper and lower gut. A study using alpha-glucosidase inhibition (acarbose). Scand J Gastroenterol. 1995; 30 892-896
- 8 Wang XL, Lu JM, Pan CY. , Comparison of serum C-reactive protein level in different glucose tolerance subjects and the change of serum CRP level in IGT subjects treated with acarbose [Chin.] Chin. J Endocrinol Metab. 2003; 19(4) 254-546
- 9 Rudofsky Jr G, Reismann P, Schiekofer S, Petrov D, Eynatten M, Humpert PM, Isermann B, Müller-Hoff C, Thai TP, Lichtenstein S, Bärtsch U, Hamann A, Nawroth P, Bierhaus A. Reduction of postprandial hyperglycemia in patients with type 2 diabetes reduces NF-kappaB activation in PBMCs. Horm Metab Res. 2004; 36 630-638
- 10 Chiasson JL, Josse RG, Gomis R, Hanefeld M, Karasik A, Laakso M. STOP-NIDDM Trail Research Group . Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial. Lancet. 2002; 359 ((9323)) 2072-2077
- 11 Chiasson JL, Josse RG, Gomis R, Hanefeld M, Karasik A, Laakso M. STOP-NIDDM Trial Research Group . Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance: the STOP-NIDDM trial. JAMA. 2003; 290 486-494
- 12 Hanefeld M, Karasik A, Koehler C, Westermeier T, Chiasson JL. Metabolic syndrome and its single traits as risk factors for diabetes in people with impaired glucose tolerance: the STOP-NIDDM trial. Diab Vasc Dis Res. 2009; 6 32-37
- 13 Temelkova-Kurktschiev T, Koehler C, Henkel E, Hanefeld M. Leukocyte count and fibrinogen are associated with carotid and femoral intima-media thickness in a risk population for diabetes. Cardiovasc Res. 2002; 56 277-283
- 14 Kempf K, Rose B, Herder C, Haastert B, Fusbahn-Laufenburg A, Reifferscheid A, Scherbaum WA, Kolb H, Martin S. The metabolic syndrome sensitizes leukocytes for glucose-induced immune gene expression. J Mol Med. 2007; 85 389-396
- 15 Hatanaka E, Monteagudo PT, Marrocos MS, Campa A. Neutrophils and monocytes as potentially important sources of proinflammatory cytokines in diabetes. Clin Exp Immunol. 2006; 146 443-447
- 16 Wijk JP van, Cabezas MC, Coll B, Joven J, Rabelink TJ, Koning EJ de. Effects of rosiglitazone on postprandial leukocytes and cytokines in type 2 diabetes. Atherosclerosis. 2006; 186 152-159
- 17 Oostrom AJ van, Plokker HW, Asbeck BS van, Rablink TJ, Kessel KP van, Jansen EH, Stehouwer CD, Cabezas MC. Effects of rosuvastatin on postprandial leukocytes in mildly hyperlipidemic patients with premature coronary sclerosis. Atherosclerosis. 2006; 185 331-339
- 18 Schiekofer S, Franke S, Andrassy M, Chen J, Rudofsky G, Schneider JG, Eynatten M von, Wendt T, Morcos M, Kientsch-Engel R, Stein G, Schleicher E, Nawroth PP, Bierhaus A. Postprandial mononuclear NF-kappaB activation is independent of the AGE-content of a single meal. Exp Clin Endocrinol Diabetes. 2006; 114 160-167
- 19 Schreiber S, Raedler A. The mucosa-associated immune system – immune defense in the gastrointestinal tract. Immun Infekt. 1993; 21 ((Suppl. 1)) 31-33
Correspondence
Prof. Dr. med. M. Hanefeld
Centre for Clinical Studies
GWT – TUD GmbH
Fiedlerstr. 34
01307 Dresden
Germany
Phone: +49/351/44 00 580
Fax: +49/351/44 00 581
Email: hanefeld@gwtonline-zks.de