O'Brien D W, Molnar G D, Petersen T D, Rajotte R V
Department of Medicine, University of Alberta, Edmonton, Canada.
Pancreas. 1990 Nov;5(6):652-7. doi: 10.1097/00006676-199011000-00004.
The purpose of the study was to examine the transhepatic and peripheral effects of somatostatin (SN) infusion on plasma glucose and insulin during insulin (IN) infusion. Hepatic blood flow was measured electromagnetically during intermittent sampling from the portal and hepatic veins, femoral artery, and right external jugular vein. Hepatic blood flow [sum of portal vein (PV) and hepatic artery] was similar during IN or IN + SN infusions. IN concentrations decreased in the portal vein from 374.8 +/- 50.3 to 295.8 +/- 25.9 pM (p less than 0.01) when SN was infused with IN. Hepatic venous plasma IN concentration also decreased from 143.6 +/- 26.6 to 88.3 +/- 10.1 pM (p less than 0.01). Plasma IN concentrations in the femoral artery and jugular vein remained unchanged. Hepatic insulin extraction changed from 64 +/- 4% during IN to 72 +/- 3% during IN + SN (p less than 0.01). Hepatic clearance and total body clearance were unchanged. Peripheral venous glucose with a nadir of 3.82 +/- 0.2 mM during IN alone decreased to a nadir of 3.16 +/- 0.27 mM (p less than 0.01) during IN + SN infusion. Mean portal venous glucose concentrations were 5.0 +/- 0.27 and 3.4 +/- 0.19 mM, respectively (p less than 0.01). In two additional experiments in which endogenous C-peptide concentrations were examined in the portal vein and femoral artery, C-peptide levels were lower during IN + SN compared to IN alone. We conclude that SN used to suppress endogenous insulin secretion increases hepatic insulin extraction, lowers glucose concentrations, and suppresses endogenous C-peptide levels to a greater extent than insulin infusion alone.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是在输注胰岛素(IN)期间,检测生长抑素(SN)输注对血浆葡萄糖和胰岛素的经肝及外周效应。在从门静脉、肝静脉、股动脉和右颈外静脉进行间歇性采样期间,通过电磁法测量肝血流量。在输注IN或IN + SN期间,肝血流量[门静脉(PV)与肝动脉之和]相似。当SN与IN一起输注时,门静脉中的IN浓度从374.8±50.3降至295.8±25.9 pM(p<0.01)。肝静脉血浆IN浓度也从143.6±26.6降至88.3±10.1 pM(p<0.01)。股动脉和颈静脉中的血浆IN浓度保持不变。肝胰岛素提取率从IN期间的64±4%变为IN + SN期间的72±3%(p<0.01)。肝清除率和全身清除率未改变。单独输注IN期间外周静脉葡萄糖最低点为3.82±0.2 mM,在IN + SN输注期间降至最低点3.16±0.27 mM(p<0.01)。平均门静脉葡萄糖浓度分别为5.0±0.27和3.4±0.19 mM(p<0.01)。在另外两项检测门静脉和股动脉内源性C肽浓度的实验中,与单独输注IN相比,IN + SN期间C肽水平更低。我们得出结论,用于抑制内源性胰岛素分泌的SN比单独输注胰岛素能更大程度地增加肝胰岛素提取、降低葡萄糖浓度并抑制内源性C肽水平。(摘要截短为250字)