Yoshida T, Mitarai Y, Nagamine K, Kobayashi M
Nihon Shokakibyo Gakkai Zasshi. 1989 Jun;86(6):1273-80.
Glucagon and insulin metabolism was studied in 9 cirrhotic patients and 4 non-cirrhotic controls. Net output of glucagon and insulin into portal circulation was calculated from difference between portal venous and systemic arterial concentrations multiplied by portal plasma flow. Metabolic clearance rate was also calculated as the ratio of the output to systemic concentration. Portal blood flow was measured by the continuous local thermodilution method. The results were as follows: 1) Arterial glucagon concentration was elevated in liver cirrhotics compared with non-cirrhotic-controls. Glucagon output in cirrhotics was higher than in controls [46.3 +/- 11.8 vs. 13.2 +/- 2.5 ng/min (mean +/- SEM), p less than 0.05]. Metabolic clearance rate of glucagon was not significantly different between the two groups. 2) There was a significant correlation between glucagon output and portal venous concentration of norepinephrine (r = 0.625, p less than 0.05). 3) Insulin levels in systemic arterial blood were higher in cirrhotic patients than non-cirrhotic subjects. Insulin output was not significantly different between the two groups, however, metabolic clearance rate of insulin in cirrhotics was reduced in comparison with the controls (274.5 +/- 44.3 vs. 557.7 +/- 108.6 ml/min, p less than 0.05).
对9名肝硬化患者和4名非肝硬化对照者的胰高血糖素和胰岛素代谢进行了研究。根据门静脉和体动脉浓度之差乘以门静脉血浆流量来计算门静脉循环中胰高血糖素和胰岛素的净输出量。代谢清除率也计算为输出量与体循环浓度的比值。采用连续局部热稀释法测量门静脉血流量。结果如下：1）与非肝硬化对照者相比，肝硬化患者的动脉胰高血糖素浓度升高。肝硬化患者的胰高血糖素输出量高于对照组[46.3±11.8 vs. 13.2±2.5 ng/分钟（平均值±标准误），p<0.05]。两组之间胰高血糖素的代谢清除率无显著差异。2）胰高血糖素输出量与门静脉去甲肾上腺素浓度之间存在显著相关性（r = 0.625，p<0.05）。3）肝硬化患者体循环动脉血中的胰岛素水平高于非肝硬化受试者。然而，两组之间的胰岛素输出量无显著差异，但与对照组相比，肝硬化患者胰岛素的代谢清除率降低（274.5±44.3 vs. 557.7±108.6 ml/分钟，p<0.05）。
