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Acipimox Acutely Increases GLP-1 Concentrations in Overweight Subjects and Hypopituitary Patients.


ABSTRACT:

Context

Glucagon-like peptide-1 (GLP-1) is an incretin hormone used therapeutically in type 2 diabetes and obesity. The interplay between ambient free fatty acids (FFAs) and GLP-1 remains unclear. Acipimox suppresses adipose tissue lipolysis via activation of the PUMA-G (also known as HCA2 and GPR109a) receptor.

Objective

To investigate whether lowering of serum FFA level with acipimox affects GLP-1 secretion.

Design

Two randomized crossover studies were performed in human subjects. Rat intestine was perfused intra-arterially and intraluminally, and l-cells were incubated with acipimox.

Participants

The participants were healthy overweight subjects and hypopituitary adult patients.

Interventions

The overweight participants received acipimox 250 mg 60 minutes before an oral glucose test. The hypopituitary patients received acipimox 250 mg 12, 9, and 2 hours before and during the metabolic study day, when they were studied in the basal state and during a hyperinsulinemic euglycemic clamp.

Results

Acipimox suppressed FFA but did not affect insulin in the clinical trials. In overweight subjects, the GLP-1 increase after the oral glucose tolerance test (area under the curve) was more than doubled [4119 ± 607 pmol/L × min (Acipimox) vs 1973 ± 375 pmol/L × min (control), P = 0.004]. In hypopituitary patients, acipimox improved insulin sensitivity (4.7 ± 0.8 mg glucose/kg/min (Acipimox) vs 3.1 ± 0.5 mg glucose/kg/min (control), P = 0.005], and GLP-1 concentrations increased ~40%. An inverse correlation between FFA and GLP-1 concentrations existed in both trials. In rat intestine, acipimox did not affect GLP-1 secretion, and l-cells did not consistently express the putative receptor for acipimox.

Conclusions

Acipimox treatment increases systemic GLP-1 levels in both obese subjects and hypopituitary patients. Our in vitro data indicate that the underlying mechanisms are indirect.

SUBMITTER: Vestergaard ET 

PROVIDER: S-EPMC7212086 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Publications

Acipimox Acutely Increases GLP-1 Concentrations in Overweight Subjects and Hypopituitary Patients.

Vestergaard Esben Thyssen ET   Hjelholt Astrid Johanneson AJ   Kuhre Rune E RE   Møller Niels N   Larraufie Pierre P   Gribble Fiona M FM   Reimann Frank F   Jessen Niels N   Holst Jens Juul JJ   Jørgensen Jens Otto Lunde JOL  

The Journal of clinical endocrinology and metabolism 20190701 7


<h4>Context</h4>Glucagon-like peptide-1 (GLP-1) is an incretin hormone used therapeutically in type 2 diabetes and obesity. The interplay between ambient free fatty acids (FFAs) and GLP-1 remains unclear. Acipimox suppresses adipose tissue lipolysis via activation of the PUMA-G (also known as HCA2 and GPR109a) receptor.<h4>Objective</h4>To investigate whether lowering of serum FFA level with acipimox affects GLP-1 secretion.<h4>Design</h4>Two randomized crossover studies were performed in human  ...[more]

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