Greenbaum C J, Havel P J, Taborsky G J, Klaff L J
Veterans Medical Center, Seattle, WA 98108.
J Clin Invest. 1991 Sep;88(3):767-73. doi: 10.1172/JCI115375.
Inhibition of pancreatic glucagon secretion during hyperglycemia could be mediated by (a) glucose, (b) insulin, (c) somatostatin, or (d) glucose in conjunction with insulin. To determine the role of these factors in the mediation of glucagon suppression, we injected alloxan while clamping the arterial supply of the pancreatic splenic lobe of dogs, thus inducing insulin deficiency localized to the ventral lobe and avoiding hyperglycemia. Ventral lobe insulin, glucagon, and somatostatin outputs were then measured in response to a stepped IV glucose infusion. In control dogs glucagon suppression occurred at a glucose level of 150 mg/dl and somatostatin output increased at glucose greater than 250 mg/dl. In alloxan-treated dogs glucagon output was not suppressed nor did somatostatin output increase. We concluded that insulin was required in the mediation of glucagon suppression and somatostatin stimulation. Subsequently, we infused insulin at high rates directly into the artery that supplied the beta cell-deficient lobe in six alloxan-treated dogs. Insulin infusion alone did not cause suppression of glucagon or stimulation of somatostatin; however, insulin repletion during glucose infusions did restore the ability of hyperglycemia to suppress glucagon and stimulate somatostatin. We conclude that intra-islet insulin permits glucose to suppress glucagon secretion and stimulate somatostatin during hyperglycemia.
(a) 葡萄糖;(b) 胰岛素;(c) 生长抑素;或 (d) 葡萄糖与胰岛素共同作用。为了确定这些因素在介导胰高血糖素抑制中的作用,我们在钳夹犬胰腺脾叶动脉供应的同时注射了四氧嘧啶,从而导致仅局限于腹侧叶的胰岛素缺乏,并避免了高血糖。然后,在静脉输注葡萄糖逐步增加的情况下,测量腹侧叶胰岛素、胰高血糖素和生长抑素的分泌量。在对照犬中,当血糖水平达到150mg/dl时胰高血糖素分泌受到抑制,当血糖高于250mg/dl时生长抑素分泌增加。在接受四氧嘧啶治疗的犬中,胰高血糖素分泌未受抑制,生长抑素分泌也未增加。我们得出结论,胰岛素是介导胰高血糖素抑制和生长抑素刺激所必需的。随后,我们以高剂量直接向6只接受四氧嘧啶治疗的犬中供应β细胞缺乏叶的动脉内输注胰岛素。单独输注胰岛素并未导致胰高血糖素分泌受抑制或生长抑素分泌增加;然而,在输注葡萄糖期间补充胰岛素确实恢复了高血糖抑制胰高血糖素和刺激生长抑素的能力。我们得出结论,胰岛内胰岛素可使葡萄糖在高血糖期间抑制胰高血糖素分泌并刺激生长抑素分泌。