Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN 37232-0615, USA.
Diabetes Obes Metab. 2011 Oct;13 Suppl 1(Suppl 1):118-25. doi: 10.1111/j.1463-1326.2011.01454.x.
Glucagon is a primary regulator of hepatic glucose production (HGP) in vivo during fasting, exercise and hypoglycaemia. Glucagon also plays a role in limiting hepatic glucose uptake and producing the hyperglycaemic phenotype associated with insulin deficiency and insulin resistance. In response to a physiological rise in glucagon, HGP is rapidly stimulated. This increase in HGP is entirely attributable to an enhancement of glycogenolysis, with little to no acute effect on gluconeogenesis. This dramatic rise in glycogenolysis in response to hyperglucagonemia wanes with time. A component of this waning effect is known to be independent of hyperglycemia, though the molecular basis for this tachyphylaxis is not fully understood. In the overnight fasted state, the presence of basal glucagon secretion is essential in countering the suppressive effects of basal insulin, resulting in the maintenance of appropriate levels of glycogenolysis, fasting HGP and blood glucose. The enhancement of glycogenolysis in response to elevated glucagon is critical in the life-preserving counterregulatory response to hypoglycaemia, as well as a key factor in providing adequate circulating glucose for working muscle during exercise. Finally, glucagon has a key role in promoting the catabolic consequences associated with states of deficient insulin action, which supports the therapeutic potential in developing glucagon receptor antagonists or inhibitors of glucagon secretion.
胰高血糖素是体内禁食、运动和低血糖时肝葡萄糖生成 (HGP) 的主要调节因子。胰高血糖素在限制肝葡萄糖摄取和产生与胰岛素缺乏和胰岛素抵抗相关的高血糖表型方面也发挥作用。对胰高血糖素的生理升高的反应中,HGP 迅速受到刺激。这种 HGP 的增加完全归因于糖原分解的增强,对糖异生几乎没有急性影响。对高胰高血糖素血症的糖原分解的这种急剧增加会随着时间的推移而减弱。这种减弱效应的一个组成部分被认为独立于高血糖,尽管这种快速脱敏的分子基础尚未完全理解。在 overnight fasted 状态下,基础胰高血糖素分泌的存在对于抵消基础胰岛素的抑制作用是必不可少的,从而维持适当的糖原分解、空腹 HGP 和血糖水平。对升高的胰高血糖素的糖原分解的增强对于低血糖的生命保护性代偿反应至关重要,并且是在运动期间为工作肌肉提供足够的循环葡萄糖的关键因素。最后,胰高血糖素在促进与胰岛素作用不足相关的分解代谢后果方面发挥关键作用,这支持了开发胰高血糖素受体拮抗剂或胰高血糖素分泌抑制剂的治疗潜力。