Goto A
Nihon Naibunpi Gakkai Zasshi. 1975 Aug 20;51(8):685-92. doi: 10.1507/endocrine1927.51.8_685.
The mode of action of sulfonylureas as hypoglycemic agent is not clarified yet. But it has been said in general to act by increasing the secretion of insulin from the beta cells. While, some believe that their effect is independent on insulin secretion. In the previous report, it was demonstrated that the oral administration of single dose of tolbutamide failed to increase immunoreactive insulin (IRI) in the peripheral vein in spite of significant decrease of blood glucose and free fatty acid levels both in normal and diabetic subjects. In order to observe changes of IRI level in the pancreatic vein following the oral administration of single dose of tolbutamide, the present study was carried out to determine serum IRI level of the pancreatic and peripheral vein in dogs. Mongrel dogs of both sexes, weighing 7-12 kg were anesthetized with sodium pentobarbital. A catheter was inserted into the superior pancreatico-duodenal vein through its duodenal branch after a laparotomy. Another catheter was inserted into the femoral vein for the collection of peripheral venous blood. The experiment was started one hour after the operation. Blood glucose level decreased gradually to 39 per cent reduction of the previous level at 180 minutes after intragastric administration of single dose of tolbutamide (0.1 g per kg). Serum IRI level in the peripheral vein showed only slight increase, similar to the response in man. While, pancreatic vein IRI level increased gradually and showed a fourfold increment after 180 minutes (from 143 muU per ml to 556 muU per ml), associated with a constant elevation of plasma tolbutamide concentration which showed 6.4 mg per 100 ml after 180 minutes. Simultaneous administration of 0.1 g per kg of tolbutamide and the same dose of sodium bicarbonate caused 49 per cent reduction of blood glucose level and a doubling of the basal IRI level in the peripheral vein. Serum IRI level in the pancreatic vein rose sharply and demonstrated a peak at 90 minutes (620 per cent increase). The elevation of plasma tolbutamide concentration was somewhat more rapid than that after tolbutamide alone. From these observations, it was confirmed that an apparent secretion of insulin into the pancreatic vein was induced by the oral administration of tolbutamide alone, in spite of the lack of increase in the peripheral vein IRI. And it is emphasized that the changes of insulin level in the pancreatic vein should be taken into account in a study of insulin dynamics.
磺脲类作为降血糖药物的作用方式尚未阐明。但一般认为其作用是通过增加β细胞胰岛素分泌来实现的。然而,一些人认为它们的作用与胰岛素分泌无关。在之前的报告中,已证明单剂量口服甲苯磺丁脲,尽管正常人和糖尿病患者的血糖及游离脂肪酸水平均显著降低,但外周静脉中免疫反应性胰岛素(IRI)并未增加。为观察单剂量口服甲苯磺丁脲后胰静脉中IRI水平的变化,本研究测定了犬胰静脉和外周静脉的血清IRI水平。选用体重7 - 12 kg的杂种犬,雌雄不限,用戊巴比妥钠麻醉。剖腹手术后,通过十二指肠分支将导管插入胰十二指肠上静脉。另一条导管插入股静脉以采集外周静脉血。术后1小时开始实验。单剂量口服甲苯磺丁脲(0.1 g/kg)后180分钟,血糖水平逐渐下降,降至给药前水平的39%。外周静脉血清IRI水平仅略有升高,与人的反应相似。而胰静脉IRI水平逐渐升高,180分钟后增加了四倍(从143 μU/ml升至556 μU/ml),同时血浆甲苯磺丁脲浓度持续升高,180分钟后达到6.4 mg/100 ml。同时给予0.1 g/kg甲苯磺丁脲和相同剂量的碳酸氢钠,血糖水平降低了49%,外周静脉基础IRI水平加倍。胰静脉血清IRI水平急剧上升,90分钟时达到峰值(增加620%)。血浆甲苯磺丁脲浓度的升高比单独使用甲苯磺丁脲时略快。从这些观察结果证实,尽管外周静脉IRI没有增加,但单剂量口服甲苯磺丁脲可诱导胰岛素明显分泌入胰静脉。并且强调在胰岛素动力学研究中应考虑胰静脉中胰岛素水平的变化。