Madsen S N
Acta Endocrinol (Copenh). 1977 Aug;85(4):760-8. doi: 10.1530/acta.0.0850760.
The glucagon stimulated increase in plasma cyclic AMP has been studied in 17 healthy subjects, in 13 hyperthyroid and in 14 hypothyroid patients. Six hyperthyroid and 2 hypothyroid patients were re-investigated after at least 15 months of treatment. The results show: 1) The glucagon stimulated cyclic AMP response is significantly increased in hyperthyroid patients considered as a group, and is reduced in patients with hypothyroidism. 2) Three hyperthyroid and 4 hypothyroid patients showed a normal response to iv glucagon, indicating that the plasma cyclic AMP response to iv glucagon is not a sensitive test for the evaluation of peripheral thyroid states. This suggests that the effects of thyroid hormones in the liver does not necessarily follow the effects in other tissues. 3) Re-investigation of treated patients showed that the cyclic AMP response can be normalized by treatment, both in hyperthyroidism and hypothyroidism. However, in patients treated for hyperthyroidism a hyper-response to glucagon can continue after blood levels of thyroid hormones are reduced to normal. This suggests an inertia in the loss of the hyper-response to glucagon, once a hyperfunction has been induced. A similar inertia in the loss of glucagon sensitivity in hypothyroidism could explain the large number of normal tests in hypothyroid patients.
对17名健康受试者、13名甲状腺功能亢进患者和14名甲状腺功能减退患者进行了胰高血糖素刺激后血浆环磷酸腺苷（cAMP）升高情况的研究。6名甲状腺功能亢进患者和2名甲状腺功能减退患者在至少接受15个月治疗后再次接受检查。结果显示：1）作为一个群体，甲状腺功能亢进患者中胰高血糖素刺激的环磷酸腺苷反应显著增加，而甲状腺功能减退患者的该反应则降低。2）3名甲状腺功能亢进患者和4名甲状腺功能减退患者对静脉注射胰高血糖素表现出正常反应，这表明静脉注射胰高血糖素后血浆环磷酸腺苷反应并非评估外周甲状腺状态的敏感试验。这提示甲状腺激素在肝脏中的作用不一定与在其他组织中的作用一致。3）对接受治疗患者的再次检查表明，无论是甲状腺功能亢进还是甲状腺功能减退，经治疗后环磷酸腺苷反应均可恢复正常。然而，在接受甲状腺功能亢进治疗的患者中，即使甲状腺激素水平降至正常，对胰高血糖素的高反应仍可能持续。这表明一旦诱发功能亢进，对胰高血糖素的高反应丧失存在惰性。甲状腺功能减退患者中胰高血糖素敏感性丧失的类似惰性可以解释甲状腺功能减退患者中大量正常检查结果的原因。
