Kreymann B, Williams G, Ghatei M A, Bloom S R
Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London.
Lancet. 1987 Dec 5;2(8571):1300-4. doi: 10.1016/s0140-6736(87)91194-9.
The physiological role of glucagon-like peptide-1 7-36 amide (GLP-1 7-36) in man was investigated. GLP-1 7-36-like immunoreactivity was found in the human bowel; its circulating level rose after oral glucose and after a test breakfast. When it was infused into seven volunteers at a rate to mimic its postprandial plasma concentration in the fasting state, plasma insulin levels rose significantly and glucose and glucagon concentrations fell. During an intravenous glucose load, it greatly enhanced insulin release and significantly reduced peak plasma glucose concentrations, compared with a control saline infusion, even inducing postinfusion reactive hypoglycaemia. By comparison, infusion of glucose-dependent insulinotropic peptide (GIP) to physiological levels was less effective in stimulating insulin release. These observations suggest that GLP-1 7-36 is a physiological incretin and that it is more powerful than GIP. The observation of greatly increased postprandial plasma GLP-1 7-36 levels in patients with postgastrectomy dumping syndrome suggests that it may mediate the hyperinsulinaemia and reactive hypoglycaemia of this disorder.
对胰高血糖素样肽-1 7-36酰胺（GLP-1 7-36）在人体中的生理作用进行了研究。在人肠道中发现了GLP-1 7-36样免疫反应性；口服葡萄糖后以及试验早餐后其循环水平升高。当以模拟其在空腹状态下餐后血浆浓度的速率将其注入7名志愿者体内时，血浆胰岛素水平显著升高，葡萄糖和胰高血糖素浓度下降。在静脉注射葡萄糖负荷期间，与对照生理盐水输注相比，它极大地增强了胰岛素释放并显著降低了血浆葡萄糖峰值浓度，甚至诱发输注后反应性低血糖。相比之下，将葡萄糖依赖性促胰岛素多肽（GIP）输注至生理水平在刺激胰岛素释放方面效果较差。这些观察结果表明GLP-1 7-36是一种生理性肠促胰岛素，且比GIP更有效。胃切除术后倾倒综合征患者餐后血浆GLP-1 7-36水平大幅升高的观察结果表明，它可能介导了该疾病的高胰岛素血症和反应性低血糖。
