Okabayashi Y, Otsuki M, Ohki A, Nakamura T, Tani S, Baba S
Second Department of Internal Medicine, Kobe University School of Medicine, Japan.
Diabetes. 1988 Sep;37(9):1173-80. doi: 10.2337/diab.37.9.1173.
Exocrine secretory function in response to 10 pM to 10 nM synthetic secretin was evaluated in perfused pancreas isolated from control, streptozocin-induced diabetic (STZ-D), alloxan-induced diabetic (ALX-D), and insulin-treated STZ-D rats. In STZ-D rats, the basal rate of pancreatic juice flow was significantly increased (10.3 +/- 1.0 microliters/20 min) compared with control rats (4.4 +/- 0.2 microliters/20 min). The basal rate of amylase output as well as pancreatic amylase content were significantly decreased to less than 5% of control values. The basal rates of protein and trypsinogen outputs were similar in both groups. In both control and diabetic rats, secretin caused a dose-dependent increase in exocrine secretion. Secretin (10 pM to 10 nM) induced 1.1- to 11.7-fold increases in exocrine secretion in STZ-D rats. These increases were significantly lower than the 2.1- to 20.8-fold increases in control rats. Furthermore, there was no significant increase in exocrine secretion from STZ-D rats in response to 10 pM secretin, although this concentration of secretin caused a significant increase in control rats. Secretin-induced exocrine secretion in ALX-D rats was similar to that in STZ-D rats. In insulin-treated STZ-D rats, the basal rates of pancreatic secretion were not significantly different from those of control rats. These results suggest that insulin resistance in this patient was due to a circulating factor of low molecular weight that uncoupled insulin stimulation of glucose transport from receptor binding and phosphorylation. The factor appears to increase the binding activity of the alpha-subunit of the insulin receptor without affecting the kinase activity of the beta-subunit.
在从对照大鼠、链脲佐菌素诱导的糖尿病(STZ-D)大鼠、四氧嘧啶诱导的糖尿病(ALX-D)大鼠以及胰岛素治疗的STZ-D大鼠分离的灌注胰腺中,评估了对外源分泌素(10 pM至10 nM)的外分泌功能。与对照大鼠(4.4±0.2微升/20分钟)相比,STZ-D大鼠的胰液基础分泌率显著增加(10.3±1.0微升/20分钟)。淀粉酶输出的基础率以及胰腺淀粉酶含量显著降低至对照值的5%以下。两组中蛋白质和胰蛋白酶原输出的基础率相似。在对照大鼠和糖尿病大鼠中,分泌素均引起外分泌分泌的剂量依赖性增加。分泌素(10 pM至10 nM)在STZ-D大鼠中诱导外分泌分泌增加1.1至11.7倍。这些增加显著低于对照大鼠中2.1至20.8倍的增加。此外,尽管该浓度的分泌素在对照大鼠中引起显著增加,但10 pM分泌素对STZ-D大鼠的外分泌分泌没有显著增加。ALX-D大鼠中分泌素诱导的外分泌分泌与STZ-D大鼠相似。在胰岛素治疗的STZ-D大鼠中,胰腺分泌的基础率与对照大鼠无显著差异。这些结果表明,该患者的胰岛素抵抗是由于一种低分子量循环因子导致胰岛素刺激的葡萄糖转运与受体结合和磷酸化解偶联。该因子似乎增加了胰岛素受体α亚基的结合活性,而不影响β亚基的激酶活性。