Lam W F, Lindeboom M E, Lamers C B, Masclee A A
Department of Gastroenterology-Hepatology, Leiden University Medical Center, Leiden, The Netherlands.
Digestion. 1999 Mar-Apr;60(2):141-6. doi: 10.1159/000007639.
BACKGROUND/AIMS: We have investigated the effect of acute hyperglycemia on pancreaticobiliary secretion and pancreatic polypeptide (PP) release.
Duodenal outputs of bilirubin, trypsin, lipase, amylase and bicarbonate were measured using a recovery marker under basal conditions and in response to modified sham feeding (MSF) in 6 healthy subjects on two separate occasions: during normoglycemia and during acute hyperglycemia (15 mmol/l).
During hyperglycemia the basal pancreaticobiliary output was significantly (p < 0.05) reduced. During normoglycemia MSF significantly (p < 0.05) increased the output of bilirubin and pancreatic enzymes; during hyperglycemia only the output of pancreatic enzymes increased significantly (p < 0.05) over basal. During MSF the outputs of bilirubin (16 +/- 4 vs. 4 +/- 2 micromol/30 min), trypsin (26 +/- 7 vs. 7 +/- 4 U/30 min), lipase (36 +/- 11 vs. 15 +/- 6 kU/30 min), amylase (3.4 +/- 0.7 vs. 1.4 +/- 0.7 kU/30 min) and bicarbonate (0.8 +/- 0.1 vs. 0.5 +/- 0.1 mmol/30 min) were significantly (p < 0.05) reduced during hyperglycemia compared to normoglycemia. During hyperglycemia basal and MSF-stimulated PP levels were significantly (p < 0.05) reduced compared to normoglycemia. MSF did not significantly influence plasma cholecystokinin levels in both experiments.
This study indicates (1) that the blood glucose levels affect basal and cephalic stimulated pancreaticobiliary secretion and (2) that the PP secretion during hyperglycemia is reduced, suggesting impaired vagal cholinergic activity during hyperglycemia.
背景/目的：我们研究了急性高血糖对胰胆分泌及胰多肽（PP）释放的影响。
在6名健康受试者中，分别于正常血糖和急性高血糖（15 mmol/l）状态下，在基础条件及模拟假饲（MSF）时，使用回收标记物测量十二指肠中胆红素、胰蛋白酶、脂肪酶、淀粉酶和碳酸氢盐的分泌量，共进行两次独立测定。
高血糖期间，基础胰胆分泌量显著降低（p < 0.05）。正常血糖时，MSF显著增加胆红素和胰酶分泌量（p < 0.05）；高血糖时，仅胰酶分泌量较基础值显著增加（p < 0.05）。MSF期间，高血糖时胆红素（16 ± 4 vs. 4 ± 2 μmol/30 min）、胰蛋白酶（26 ± 7 vs. 7 ± 4 U/30 min）、脂肪酶（36 ± 11 vs. 15 ± 6 kU/30 min）、淀粉酶（3.4 ± 0.7 vs. 1.4 ± 0.7 kU/30 min）和碳酸氢盐（0.8 ± 0.1 vs. 0.5 ± 0.1 mmol/30 min）的分泌量与正常血糖相比显著降低（p < 0.05）。与正常血糖相比，高血糖时基础及MSF刺激后的PP水平显著降低（p < 0.05）。在两个实验中，MSF均未显著影响血浆胆囊收缩素水平。
本研究表明：（1）血糖水平影响基础及头相刺激的胰胆分泌；（2）高血糖时PP分泌减少，提示高血糖期间迷走胆碱能活性受损。
