Arvat E, Maccagno B, Ramunni J, Giordano R, Broglio F, Gianotti L, Maccario M, Camanni F, Ghigo E
Division of Endocrinology, Department of Internal Medicine, University of Turin, Turin, Italy.
Eur J Endocrinol. 2000 Nov;143(5):601-6. doi: 10.1530/eje.0.1430601.
Glucagon administration stimulates both somatotroph and corticotroph secretion in humans, although this happens only if glucagon is administered by the intramuscular route and not by the intravenous route. On the other hand, GH secretagogues (GHS) strongly stimulate GH and also possess ACTH-releasing activity.
To clarify the mechanisms underlying the stimulatory effects of both glucagon and GHS on somatotroph and corticotroph secretion, we studied the GH, ACTH and cortisol responses to glucagon (GLU, 0.017 mg/kg i.m.) and Hexarelin, a peptidyl GHS (HEX, 2.0 microg/kg i.v.) given alone or in combination in 6 normal young volunteers (females, aged 26-32 years, body mass index 19.7-22.5 kg/m).
GLU administration elicited a clear increase in GH (peak vs baseline, mean+/-S.E.M.: 11.6+/-3.4 vs 3. 3+/-0.7 microg/l, P<0.02), ACTH (11.6+/-3.3 vs 4.1+/-0.3 pmol/l, P<0. 02) and cortisol (613.5+/-65.6 vs 436.9+/-19.3 nmol/l, P<0.05) levels. HEX induced a marked increase in GH levels (55.7+/-19.8 vs 3. 7+/-1.9 microg/l, P<0.005) and also significant ACTH (5.7+/-1.1 vs 3. 4+/-0.6 pmol/l, P<0.01) and cortisol (400.2+/-31.4 vs 363.4+/-32.2 nmol/l, P<0.05) responses. The GH area under the curve (AUC) after HEX was clearly higher than after GLU (1637.3+/-494.0 vs 479.1+/-115. 7 microg/l/120 min, P<0.04) while HEX and GLU coadministration had a true synergistic effect on GH release (3243.8+/-687.5 microg/l/120 min, P<0.02). The ACTH and cortisol AUCs after HEX were lower (P<0. 02) than those after GLU (208.3+/-41.3 vs 426.3+/-80.9 pmol/l/120 min and 18 874.5+/-1626.1 vs 28 338.5+/-2430.7 nmol/l/120 min respectively). The combined administration of HEX and GLU had an effect which was less than additive on both ACTH (564.02+/-76.5 pmol/l/120 min) and cortisol (35 424.6+/-5548.1 nmol/l/120 min) secretion.
These results show that the intramuscular administration of glucagon releases less GH but more ACTH and cortisol than Hexarelin. The combined administration of glucagon and Hexarelin has a true synergistic effect on somatotroph secretion but a less than additive effect on corticotroph secretion; these findings suggest that these stimuli act via different mechanisms to stimulate somatotrophs while they could have a common action on the hypothalamo-pituitary-adrenal axis.
在人类中,注射胰高血糖素可刺激生长激素分泌细胞和促肾上腺皮质激素分泌细胞的分泌,不过这种情况仅在通过肌肉注射而非静脉注射胰高血糖素时才会发生。另一方面,生长激素促分泌素(GHS)能强烈刺激生长激素分泌,并且还具有促肾上腺皮质激素释放活性。
为阐明胰高血糖素和GHS对生长激素分泌细胞和促肾上腺皮质激素分泌细胞分泌的刺激作用背后的机制,我们研究了6名正常年轻志愿者(女性,年龄26 - 32岁,体重指数19.7 - 22.5kg/m²)单独或联合注射胰高血糖素(GLU,0.017mg/kg,肌肉注射)和一种肽类GHS——司来吉兰(HEX,2.0μg/kg,静脉注射)后生长激素、促肾上腺皮质激素和皮质醇的反应。
注射GLU后,生长激素(峰值与基线相比,均值±标准误:11.6±3.4 vs 3.3±0.7μg/L,P<0.02)、促肾上腺皮质激素(11.6±3.3 vs 4.1±0.3pmol/L,P<0.02)和皮质醇(613.5±65.6 vs 436.9±19.3nmol/L,P<0.05)水平明显升高。HEX使生长激素水平显著升高(55.7±19.8 vs 3.7±1.9μg/L,P<0.005),同时促肾上腺皮质激素(5.7±1.1 vs 3.4±0.6pmol/L,P<0.01)和皮质醇(400.2±31.4 vs 363.4±32.2nmol/L,P<0.05)也有明显反应。HEX后的生长激素曲线下面积(AUC)明显高于GLU(1637.3±494.0 vs 479.1±115.7μg/L/120分钟,P<0.04),而联合注射HEX和GLU对生长激素释放具有真正的协同作用(3243.8±687.5μg/L/120分钟,P<0.02)。HEX后的促肾上腺皮质激素和皮质醇AUC低于GLU(分别为208.3±41.3 vs 426.3±80.9pmol/L/120分钟和18874.5±1626.1 vs 28338.5±2430.7nmol/L/120分钟,P<0.02)。联合注射HEX和GLU对促肾上腺皮质激素(564.02±76.5pmol/L/120分钟)和皮质醇(35424.6±5548.1nmol/L/120分钟)分泌的作用小于两者相加的效果。
这些结果表明,肌肉注射胰高血糖素释放的生长激素比司来吉兰少,但促肾上腺皮质激素和皮质醇更多。联合注射胰高血糖素和司来吉兰对生长激素分泌细胞分泌具有真正的协同作用,但对促肾上腺皮质激素分泌细胞分泌的作用小于两者相加的效果;这些发现表明,这些刺激通过不同机制刺激生长激素分泌细胞,而它们可能对下丘脑 - 垂体 - 肾上腺轴有共同作用。