Miglitol suppresses the postprandial increase in interleukin 6 and enhances active glucagon-like peptide 1 secretion in viscerally obese subjects

• Published in: Metabolism, clinical and experimental Vol. 57; no. 9; pp. 1299 - 1306
• Main Authors: Arakawa, Masayuki, Ebato, Chie, Mita, Tomoya, Fujitani, Yoshio, Shimizu, Tomoaki, Watada, Hirotaka, Kawamori, Ryuzo, Hirose, Takahisa
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-09-2008; Elsevier
• Subjects: 1-Deoxynojirimycin - analogs & derivatives; 1-Deoxynojirimycin - therapeutic use; Acarbose - therapeutic use; Adult; Biological and medical sciences; Blood Glucose - metabolism; Cross-Over Studies; Endocrinology & Metabolism; Enzyme Inhibitors - therapeutic use; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Glucagon-Like Peptide 1 - blood; Glucagon-Like Peptide 1 - secretion; Humans; Insulin - administration & dosage; Insulin - blood; Insulin - therapeutic use; Intercellular Adhesion Molecule-1 - blood; Interleukin-6 - antagonists & inhibitors; Interleukin-6 - blood; Lipids - blood; Lipoprotein Lipase - blood; Male; Medical sciences; Metabolic diseases; Middle Aged; Obesity; Obesity - blood; Obesity - drug therapy; Obesity - metabolism; Postprandial Period; Single-Blind Method; Vascular Cell Adhesion Molecule-1 - blood; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Viscera; Human; Obesity; Enzyme; Postprandial; Secretion; Miglitol; Cytokine; Nutrition disorder; Enzyme inhibitor; Increase; Glucagon like peptide 1; Glycosylases; Interleukin 6; Hypoglycemic agent; Gastrointestinal hormone; α-Glucosidase; Glycosidases; Hydrolases; Endocrinology; Nutritional status
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1016/j.metabol.2008.04.027

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.