Synthesis and biological evaluation of benzocyclobutane-C-glycosides as potent and orally active SGLT1/SGLT2 dual inhibitors

Synthesis and biological evaluation of benzocyclobutane-C-glycosides as potent and orally active SGLT1/SGLT2 dual inhibitors are described. Compound 19 showed high inhibitory potency at SGLT1 (IC₅₀?=?45?nM), and excellent potency at SGLT2 (IC₅₀?=?1?nM). It also displayed excellent PK profiles in mice, rats, dogs and monkeys (F?=?78–107%). In SD rats, compound 19 treatments significantly reduced blood glucose levels in a dose-dependent manner. In ZDF rats, compound 19 displayed anti-hyperglycemic effect up to 24?h. Therefore, compound 19 may serve as valuable pharmacological tool, and potential use as a treatment for metabolic syndrome.     

C-aryl glucosides substituted at the 4'-position as potent and selective renal sodium-dependent glucose co-transporter 2 (SGLT2) inhibitors for the treatment of type 2 diabetes

A series of C-aryl glucosides with various substituents at the 4′-position of the distal aryl ring have been synthesized and evaluated for inhibition of hSGLT1 and hSGLT2. Introduction of alkyl or alkoxy substituents at the 4′-position was found to improve SGLT2 potency, whereas introduction of a hydrophilic group at this position was deleterious. Compounds with alkoxy-, cycloalkoxy- or cycloalkenyloxy-ethoxy scaffolds exhibited good inhibitory activity and high selectivity toward SGLT2. Selected compounds were investigated for in vivo efficacy.     

Synthesis and biological evaluation of 6-hydroxyl C-aryl glucoside derivatives as novel sodium glucose co-transporter 2 (SGLT2) inhibitors

The sodium glucose co-transporter 2 (SGLT2) was considered as an important target for the treatment of type 2 diabetes mellitus in recent years. This report describes the design and synthesis of a series of novel SGLT2 inhibitors (11a–17a) as well as their dehydrate dihydrofuran derivatives (11b–17b), which were prepared by Mitsunobu reaction. Their SGLT2 inhibitory activity was also evaluated, and 16a and 17a were found to be the most potent compounds with IC₅₀ values of 0.63 and 0.81?nM, respectively. However, all the dehydrate derivatives lose the SGLT2 inhibitory activity, with inhibition percentage no more than 66.5% at the concentration of 0.5?μM, which might because of the configuration inversion at C-2 of glucose. In conclusion, the present study improves understanding of the SAR of SGLT2 inhibitors, and provided more information that could be applied to design new molecules.     

Synthesis and biological evaluation of pyrrolidine-2-carbonitrile and 4-fluoropyrrolidine-2-carbonitrile derivatives as dipeptidyl peptidase-4 inhibitors for the treatment of type 2 diabetes

A novel series of pyrrolidine-2-carbonitrile and 4-fluoropyrrolidine-2-carbonitrile derivatives was designed, synthesized, and found to act as dipeptidyl peptidase-4 (DPP-4) inhibitors. From this series of compounds, compound 17a was identified as an efficacious, safe, and selective inhibitor of DPP-4. In vivo studies in ICR and KKAy mice showed that administration of this compound resulted in decreased blood glucose in these mice after an oral glucose challenge. Compound 17a showed high DPP-4 inhibitory activity (IC₅₀ = 0.017 μM), moderate selectivity against DPP-4 (selective ratio: DPP-8/DPP-4 = 1324; DPP-9/DPP-4 = 1164), and good efficacy in oral glucose tolerance tests in ICR and KKAy mice. These in vivo anti-diabetic properties and its desirable pharmacokinetic profile in Sprague–Dawley rats demonstrate that compound 17a is a promising candidate for development as an anti-diabetic agent.     

C-Glucosides with heteroaryl thiophene as novel sodium-dependent glucose cotransporter 2 inhibitors

Canagliflozin (1), a novel inhibitor for sodium-dependent glucose cotransporter 2 (SGLT2), has been developed for the treatment of type 2 diabetes. To investigate the effect of replacement of the phenyl ring in 1 with heteroaromatics, C-glucosides 2 were designed, synthesized, and evaluated for their inhibitory activities against SGLT2. Of these, 3-pyridyl, 2-pyrimidyl or 5-membered heteroaryl substituted derivatives showed highly potent inhibitory activity against SGLT2, while 5-pyrimidyl substitution was associated with slightly reduced activity. In particular, 2g (TA-3404) had remarkable anti-hyperglycemic effects in high-fat diet fed KK (HF-KK) mice.     

Novel protein tyrosine phosphatase 1B inhibitors: interaction requirements for improved intracellular efficacy in type 2 diabetes mellitus and obesity control

Resistance to the hormones insulin and leptin are hallmarks in common for type 2 diabetes mellitus and obesity. Both conditions are associated with increased activity and expression of protein tyrosine phosphatase (PTP)1B. Therefore, inhibition of PTP1B activity or down-regulation of its expression should ameliorate insulin and leptin resistance, and may hold therapeutic utility in type 2 diabetes mellitus and obesity control. This background has motivated the fervent search for PTP1B inhibitors, carried out in the recent years. The purpose of this review is to provide the most recent advances in understanding the structural details of PTP1B molecule relevant to the interactions with inhibitors, and the progress towards compounds with enhanced membrane permeability, affinity, specificity, and potency on intracellular PTP1B; several inhibitors of benefit in type 2 diabetes mellitus and obesity control are presented and discussed.     

Discovery of a potent,low-absorbable sodium-dependent glucose cotransporter 1 (SGLT1) inhibitor (TP0438836) for the treatment of type 2 diabetes

The design and synthesis of a novel class of low-absorbable SGLT1 inhibitors are described. To achieve low absorption in the new series, we performed an optimization study based on a strategy to increase TPSA. Fortunately, the optimization of an aglycon moiety and a side chain of the distal aglycon moiety led to the identification of compound 30b as a potent and low-absorbable SGLT1 inhibitor. Compound 30b showed a desirable PK profile in Sprague-Dawley (SD) rats and a favorable glucose-lowering effect in diabetic rats.     

脂蛋白脂酶基因多态性与2 型糖尿病的相关性研究

目的：探讨脂蛋白脂酶（lipoprotein lipase,LPL）基因PvuⅡ酶切多态性与2型糖尿病的相关性。方法：采用聚合酶链反应-限制性片段长度多态性（PGR-RFLP）方法,分析了156例样本LPL基因第6内含子PvuⅡ多态性（病例组98人。对照组58。其中40个2型糖尿病同胞对,病例组40人,对照组40人）。结果：病例组与对照组的基因型和基因频率均无显著性差异。结论：湖北汉族人群脂蛋白脂酶基因PvuⅡ酶切多态性与2型糖尿病无明显关联。     

肠道菌群对2型糖尿病的调节机制

2型糖尿病(type 2 diabetes mellitus,T2DM)是一种遗传和环境因素共同作用的复杂的代谢性疾病,约占糖尿病患者总数的90％以上.以往,人们一直认为导致T2DM发生的肥胖是外部因素所致,但目前已有证据表明,身体内部因素同样是导致肥胖的诱因之一.人体微生物群的最新研究表明,个体肠道中的特定菌群可能促...     

Calpain10基因多态性与2 型糖尿病的相关性研究

目的：探讨钙蛋白酶10（Calpain10）基因第3内含子SNP19多态性在湖北汉族人群2型糖尿痛发生发展中的作用。方法：采用同胞对（家系内对照）和随机病例-对照两种实验设计,结合聚合酶链反应-限制性片断长度多态性（PCR-RFLP）．技术分析共403个样本的Calpain10基因第3内合子SNP19多态性,并测定身高、体重、腰围、臀围、血压和空腹血糖等生理指标。结果：两种实验设计中对照组与病例组的基因型和基因频率均无显著差异（PO．05）。结论：Calpain10基因SNP19多态性在湖北汉族人群2型糖尿病的发生发展中可能不起主要作用。     

含乳杆菌的益生菌制剂干预2型糖尿病疗效及安全性的Meta分析

系统评价益生菌类制剂治疗2型糖尿病的疗效及安全性,尤其是包含乳杆菌的益生菌制剂的疗效。

运用计算机检索Embase、Cochrane、Pubmed数据库,搜索益生菌干预2型糖尿病的临床随机对照试验。应用Review manager 5.4.1软件进行Meta分析,最终纳入16项研究,包含1 015名患者。

试验组的干预方式在改善患者空腹血糖[SMD = –0.37,95% CI（–0.52,–0.23）,P＜0.01]、改善胰岛素抵抗[SMD = –0.39,95% CI（–0.55,–0.24）,P＜0.01]、提高高密度脂蛋白[SMD = 0.22,95% CI（0.07,0.38）,P＜0.01]、降低甘油三酯[SMD = –0.18,95% CI（–0.33,–0.03）,P = 0.02]水平方面优于对照组,而在患者体质量指数[MD = 0.27,95% CI（–0.45,1.00）,P = 0.46]、胆固醇[SMD = 0.01,95% CI（–0.13,0.15）,P = 0.94]、高敏C-反应蛋白[SMD = –0.15,95% CI（–0.33,0.02）,P = 0.09]、收缩压[MD = –0.76,95% CI（–2.77,1.26）,P = 0.46]、舒张压[MD = –0.29,95% CI（–1.75,1.18）,P = 0.70]方面差异均无统计学意义。16项研究中有4项研究报道了不良反应,主要包括腹泻、便秘、头痛。

含有乳杆菌的益生菌制剂可改善糖尿病患者空腹血糖、胰岛素抵抗、甘油三酯等水平。

     

DNA polymorphism analysis of candidate genes for type 2 diabetes mellitus in a Mexican ethnic group

Type 2 diabetes mellitus is a complex metabolic disorder resulting from the action and interaction of many genetic and environmental factors. It has been reported that polymorphisms in genes involved in the metabolism of glucose are associated with the susceptibility to develop type 2 diabetes mellitus. Although the risk of developing type 2 diabetes mellitus increases with age, as well as with obesity and hypertension, its prevalence and incidence are different among geographical regions and ethnic groups. In Mexico, a higher prevalence and incidence has been described in the south of the country, and differences between urban and rural communities have been observed.We studied 73 individuals from Santiago Jamiltepec, a small indigenous community from Oaxaca State, Mexico. This population has shown a high prevalence of type 2 diabetes mellitus, and the aim of this study was to analyze the relationship between the Pst I (insulin gene), Nsi I (insulin receptor gene) and Gly972Arg (insulin receptor substrate 1 gene) polymorphisms and type 2 diabetes mellitus, obesity and hypertension in this population. Clinical evaluation consisted of BMI and blood pressure measurements, and biochemical assays consisted of determination of fasting plasma insulin and glucose levels. PCR and restriction enzyme digestion analysis were applied to genomic DNA to identify the three polymorphisms. From statistical analysis carried out here, individually, the Pst I, Nsi I and Gly972Arg polymorphisms were not associated with the type 2 diabetes, obese or hypertensive phenotypes in this population. Nevertheless, there was an association between the Nsi I and Pst I polymorphisms and increased serum insulin levels.     

2型糖尿病与糖尿病肾病患者微炎症及肠道微生物多样性分析

目的 分析2型糖尿病(T2DM)及糖尿病肾病(DKD)患者微炎症情况和肠道微生物多样性。 方法 将2016年4月至2019年7月在我院进行治疗的68例T2DM患者(T2DM组)和57例DKD患者(DKD组)纳入研究,选择同期于我院进行健康体检的36例志愿者作为对照组。收集3组对象一般资料、血液标本和粪便标本,测定血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)、高密度脂蛋白胆固醇(HDLC)、糖化血红蛋白(HbAlc)、空腹血糖(FBG)、超敏C反应蛋白(hsCRP)、白细胞介素6(IL6)水平,并对肠道细菌进行16S rDNA序列测序。比较3组对象一般资料,血液指标,肠道菌群门水平构成情况,肠道菌群多样性,肠道菌属差异性,并对患者炎性指标与菌群种类进行相关性分析。 结果 DKD组患者糖尿病病程长于T2DM组(P结论 2型糖尿病患者普遍存在微炎症和肠道菌群失衡,微炎症程度与肾脏病变和肠道菌群数量密切相关。T2DM与DKD患者在肠道菌群结构上具有一致性和差异性,肠道菌群检测有可能成为预测T2DM患者发生肾脏病变的风险指标。     

Discovery of a novel olefin derivative as a highly potent and selective acetyl-CoA carboxylase 2 inhibitor with in vivo efficacy

Novel acetyl-CoA carboxylase 2 (ACC2) selective inhibitors were identified by the conversion of the alkyne unit of A-908292 to the olefin linker. Modification of the center and left part of the lead compound 1b improved the ACC2 inhibitory activity and CYP450 inhibition profile, and afforded a highly selective ACC2 inhibitor 2e which showed in vivo efficacy in C57BL/6 mice.     

磺酰脲受体1基因多态性与2型糖尿病的相关性

目的：研究磺酰脲受体1（sulfonylurea receptorl,SUR1）基因外显子16-3c／t多态性与湖北汉族人群2型糖尿病的相关性。方法：采用同胞对（2型糖尿病人及其正常同胞）和随机病例一对照两种实验设计,应用PCR-RFLP方法分析共405个样本的SUR1基因外显子16-3c／t多态性,并测定身高、体重、腰围、臀围、血压、空腹血糖等生理生化指标。结果：两种实验设计中病例组与对照组的基因型和等位基因频率均无显著性差异（P〉0．05）。结论：在湖北汉族人群中未发现SUR1基因外显子16-3c／t多态性与2型糖尿病之间存在关联,该基因座可能不是该人群的致病基因。     

SGLT2抑制剂对2型糖尿病患者血糖、血尿酸水平及心脏功能的影响

摘要 目的：研究SGLT2抑制剂对2型糖尿病患者血糖、血尿酸水平及心脏功能的影响。方法：选取我院2019年1月~2020年6月收治的2型糖尿病合并稳定性心功能不全患者106例为研究对象,采用随机数字表法将患者分为两组,所有患者均给予2型糖尿病饮食控制治疗方案,并给予心功能不全对症药物治疗。对照组患者在此基础上给予二甲双胍,观察组在对照组的基础上给予SGLT2抑制剂达格列净。比较两组患者的血糖、血尿酸（uric acid,UA）、血清脑钠肽(brainnatriureticpeptide,BNP)水平、心脏功能及生活质量。结果：治疗前两组的餐后2 h血糖（2- hour postprandial glucose,2 h PBG）、空腹血糖（fasting blood glucose,FBG）及糖化血红蛋白（glycosylated hemoglobin,HbAIc）水平比较无差异（P＞0.05）,治疗后两组的上述指标均显著降低,且观察组显著低于对照组（P<0.05）;治疗前两组的UA和BNP水平比较无差异（P＞0.05）,治疗后两组的上述指标均显著降低,且观察组显著低于对照组（P<0.05）;治疗前两组的左室射血分数（left ventricular ejection fraction,LVEF）和左室舒张末期内径（left ventricular end diastolic diameter,LVEDD）水平比较无差异（P＞0.05）,治疗后观察组的LVEF水平显著升高,LVEDD水平显著降低（P<0.05）,但对照组治疗前后比较无差异（P＞0.05）;治疗前两组的SF-36健康调查量表(the SF-36 Health Survey,SF-36)评分比较无差异（P＞0.05）,治疗后两组的SF-36评分均显著上升,且观察组显著高于对照组（P<0.05）,两组的不良反应发生率比较无统计学差异（P＞0.05）。结论：达格列净可显著改善2型糖尿病合并稳定性心功能不全患者的血糖、血尿酸水平,还能够改善患者的心脏功能,值得临床借鉴。     

黄连素调节肠道菌群治疗2型糖尿病的机制研究进展

2型糖尿病（type 2 diabetes mellitus,T2DM）主要由胰岛素分泌的相对和/或绝对缺乏引起,因其高发病率、高致残率已成为全球公共卫生领域面临的共同难题。由肥胖、氧化应激和慢性炎症等原因引起的胰岛素抵抗是其主要的发病机制之一。黄连素是一种安全性高、不良反应低、具有多种药理作用的天然的五环异喹啉类生物碱。然而黄连素在动物模型中的口服生物利用度极低,提示肠道菌群可能是其发挥多重药理作用的靶点。肠道菌群被称为“第二基因组”,通过调节代谢物、微生物－肠－脑轴、炎症反应、肠道激素和氧化应激影响T2DM。本文以综述的形式分析了黄连素调节肠道菌群在T2DM治疗中的作用机制,以期为T2DM及其他代谢性疾病的治疗提供新的思路。

     

Effects of sodium glucose cotransporter-2 inhibitors on serum uric acid in type 2 diabetes mellitus: A systematic review with an indirect comparison meta-analysis

To describe the effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors on serum uric acid (SUA) in patients with type 2 diabetes mellitus (T2DM). PubMed, EMBASE, and CENTRAL were searched for randomized controlled trials of SGLT2 inhibitors in patients with T2DM up to Aug 10, 2017, without language or date restrictions. Thirty-one studies totaling 13,650 patients were included. SGLT2 inhibitors significantly decreased SUA levels compared with placebo, canagliflozin WMD –37.02?μmol/L, 95% CI [–38.41, –35.63], dapagliflozin WMD –38.05?μmol/L, 95% CI [–44.47, –31.62], empagliflozin WMD –42.07?μmol/L, 95% CI [–46.27, –37.86]. The drug class effect of SUA reduction suggesting SGLT2 inhibitors might be beneficial for diabetic patients with hyperuricemia.     

Induction and removal of DNA damage in blood leukocytes of patients with type 2 diabetes mellitus undergoing hemodialysis

Type 2 diabetes mellitus (T2DM) is associated with a high production of reactive oxygen species, which may cause oxidative DNA damage. High levels of genomic damage have been associated with renal failure and hemodialysis. However, no information is available in the literature concerning the levels of DNA damage in T2DM individuals who are dependent on hemodialysis. This study used the comet assay to assess the levels of DNA damage before, immediately after and 48 h after the hemodialysis session in 25 patients with T2DM and in a group of 20 healthy individuals, selected according to mean age, sex and smoking habit. Our results showed increased levels of DNA damage in hemodialysis-dependent T2DM individuals (12.36 ± 8.04) when compared with healthy individuals (7.35 ± 7.41) (p = 0.014). Damage levels increased immediately after the hemodialysis session (19.76 ± 12.40) (p = 0.04), which suggests a possible action of pro-oxidative factors related to the therapy, with a genotoxic effect on cells. Results obtained 48 h after hemodialysis (6.44 ± 5.99) evidenced damage removal (p = 0.001), which may be suggestive of DNA repair.     

Design,synthesis and biological evaluation of novel pyrimidinedione derivatives as DPP-4 inhibitors

A series of novel pyrimidinedione derivatives were designed and evaluated for in vitro dipeptidyl peptidase-4 (DPP-4) inhibitory activity and in vivo anti-hyperglycemic efficacy. Among them, the representative compounds 11, 15 and 16 showed excellent inhibitory activity of DPP-4 with IC₅₀ values of 64.47?nM, 188.7?nM and 65.36?nM, respectively. Further studies revealed that compound 11 was potent in vivo hypoglycemic effect. The structure–activity relationships of these pyrimidinedione derivatives had been discussed, which would be useful for developing novel DPP-4 inhibitors as treating type 2 diabetes.