Yki-Järvinen H, Pelkonen R, Koivisto V A
Clin Endocrinol (Oxf). 1985 Oct;23(4):461-6. doi: 10.1111/j.1365-2265.1985.tb01104.x.
In order to study the suppression of C-peptide secretion in 5 patients with insulin-producing tumours or beta cell hyperplasia, we raised and maintained plasma insulin at a high physiological level and kept plasma glucose unchanged for 2 h with combined infusions of glucose and insulin (insulin clamp technique). No suppression of C-peptide secretion was seen in any of the patients, in contrast with a 35-65% decline seen in each of 17 healthy control subjects. In 3 patients surgical removal of beta cell adenoma normalized the response, whereas it remained unchanged in a patient with beta cell hyperplasia after partial pancreatectomy and in another with inoperable carcinoma. These results indicate that insulin secretion by insulinomas is characterized by lack of suppression by insulin. Measurement of the insulin-insulin feedback loop by the clamp technique may provide a rapid test to reveal autonomous insulin secretion without the risk of hypoglycaemia.
为了研究5例胰岛素瘤或β细胞增生患者的C肽分泌抑制情况，我们通过联合输注葡萄糖和胰岛素（胰岛素钳夹技术）将血浆胰岛素维持在高生理水平，并使血浆葡萄糖在2小时内保持不变。与17名健康对照者中每人出现35%-65%的下降相反，所有患者均未观察到C肽分泌受到抑制。在3例患者中，手术切除β细胞腺瘤使反应恢复正常，而在1例部分胰腺切除术后的β细胞增生患者和另1例无法手术的癌症患者中，反应保持不变。这些结果表明，胰岛素瘤的胰岛素分泌特点是不受胰岛素抑制。通过钳夹技术测量胰岛素-胰岛素反馈回路，可能提供一种快速检测方法，以揭示自主性胰岛素分泌，而无低血糖风险。
