Martino F, Baviera G, Bonanno N, Purello D'Ambrosio F
Riv Eur Sci Med Farmacol. 1989 Aug;11(4):329-39.
Glucose intolerance in uremic patients is often reported in literature. This condition is characterized by an unbalance between production and utilization of glucose as for a trouble of the mechanism of gluco-metabolic regulation. Insulin radioimmunoassay (IRI) is measured to know the amount of hormone incretion and to verify its efficacy in the glucose utilization. The glucagon load and the double glucagon load are tests employed to study IRI response and glucose metabolism in uremia. With the double administration of glucagon is possible to assess the degree of glycogenolysis, but also the neo-glycogenesis stimulated by the first glucagon injection. This aspect is important because it reflects the sensitivity for the agent of counter-regulation hormonal (especially glucagon). The test performed by double glucagon load produces in uremic subjects IRI curves characterized by two peaks and unbalance amount between the 1st and the 2nd area correspondent to glucagon loads. Both the phases are higher than phases of normal subjects and the ratio 2nd/1st is 1.5. The behaviour of all the responsive IRI curves is similar and sufficiently homogeneous to permit its representation by medium values observed step by step in the group. The plasma glucose responses are dishomogeneous and it is possible to emphasize different types of involvement in the glucose intolerance.
文献中经常报道尿毒症患者存在葡萄糖耐量异常。这种情况的特征是葡萄糖生成与利用之间失衡，这是糖代谢调节机制出现问题所致。测量胰岛素放射免疫测定（IRI）以了解激素分泌量并验证其在葡萄糖利用中的功效。胰高血糖素负荷试验和双重胰高血糖素负荷试验用于研究尿毒症患者的IRI反应和葡萄糖代谢。通过双重给予胰高血糖素，不仅可以评估糖原分解程度，还可以评估首次注射胰高血糖素所刺激的糖原异生程度。这一点很重要，因为它反映了机体对反调节激素（尤其是胰高血糖素）的敏感性。双重胰高血糖素负荷试验在尿毒症患者中产生的IRI曲线具有两个峰值，且对应于胰高血糖素负荷的第一和第二区域之间的量不平衡。两个阶段均高于正常受试者的阶段，第二阶段与第一阶段的比值为1.5。所有反应性IRI曲线的行为相似且足够均匀，以便可以用该组中逐步观察到的平均值来表示。血浆葡萄糖反应不均匀，并且有可能突出葡萄糖耐量异常的不同类型。
