Division of Diabetology and Gastrointestinal Endocrinology, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstrasse 56, 44791 Bochum, Germany.
J Clin Endocrinol Metab. 2012 May;97(5):E791-5. doi: 10.1210/jc.2011-3439. Epub 2012 Mar 7.
Postprandial hyperglucagonemia is frequently found in patients with diabetes. Recently, a loss of the inverse relationship between pulsatile insulin and glucagon secretion has been reported in patients with type 2 diabetes. The crosstalk between pulsatile islet hormone secretion in prediabetic individuals has not yet been examined.
Eleven individuals with impaired glucose tolerance and/or impaired fasting glucose and 13 nondiabetic controls were examined after mixed meal ingestion. Glucose, insulin, and glucagon levels were determined frequently and analyzed by deconvolution and cross-correlation methods.
Postprandial glucose levels were higher in prediabetic individuals (P = 0.017). Insulin concentrations were not different between the groups (P = 0.29). Postprandial glucagon levels were higher in the impaired glucose tolerance/impaired fasting glucose individuals (P = 0.039). Pulsatile insulin and glucagon secretion was apparent in both groups, but there were no differences in the frequency or mass of insulin and glucagon pulses between the groups. An inverse relationship between the insulin and glucagon concentration time curves was found in the control subjects (P < 0.05). This association was not detectable in the prediabetic individuals.
Increased postprandial glucagon concentrations in prediabetic individuals are accompanied by a loss of the pulsatile insulin-glucagon crosstalk. This suggests that disturbances in islet hormone pulsatility precede the actual manifestation of hyperglycemia.
餐后高胰高血糖素血症在糖尿病患者中很常见。最近，有报道称 2 型糖尿病患者的脉冲式胰岛素和胰高血糖素分泌之间的反向关系丧失。在糖尿病前期个体中，关于脉冲式胰岛激素分泌的串扰尚未被研究。
11 名糖耐量受损和/或空腹血糖受损的个体以及 13 名非糖尿病对照者在混合餐摄入后接受检查。频繁测定葡萄糖、胰岛素和胰高血糖素水平，并通过解卷积和互相关方法进行分析。
糖尿病前期个体的餐后血糖水平较高（P = 0.017）。两组之间的胰岛素浓度没有差异（P = 0.29）。糖耐量受损/空腹血糖受损个体的餐后胰高血糖素水平较高（P = 0.039）。两组均可见脉冲式胰岛素和胰高血糖素分泌，但两组之间的胰岛素和胰高血糖素脉冲的频率或幅度没有差异。在对照组中发现了胰岛素和胰高血糖素浓度时间曲线之间的反向关系（P < 0.05）。在糖尿病前期个体中，这种关联无法检测到。
糖尿病前期个体餐后胰高血糖素浓度升高，同时脉冲式胰岛素-胰高血糖素串扰丧失。这表明胰岛激素脉冲的紊乱先于高血糖的实际表现。
