Van Haeften T W, Van Faassen I, Van der Veen E A
Department of Endocrinology, Free University Hospital, Amsterdam, The Netherlands.
Diabetes Res. 1988 Dec;9(4):187-91.
Glucose and arginine are both known to be potent insulin secretagogues and to potentiate each others insulin secretion. We investigated if repetitive infusion of arginine leads to comparable insulin secretion during fasting and if the additional infusion of glucose leads to a change in the pattern of the insulin secretion during repeated infusion of arginine. Repeated continuous infusions of arginine (0.3 g/kg in 30 min) in six normals led to a lower second phase insulin secretion during the third infusion (p less than 0.05). Pre-stimulus blood glucose levels were lower before the third infusion than before the first infusion (p less than 0.05). Repeated hyperglycaemic clamps (17.5 mmol/l during 30 min) led to comparable insulin secretion during three infusion. Combined infusion of arginine and glucose (hyperglycaemic clamps) did not lead to a decrease during the third infusion. We conclude first, that concomitant hyperglycemia potentiates second phase insulin secretion and second, that prolonged fasting leads to an adaptation of the pancreas B-cell leading to diminished arginine-induced insulin secretion, which can be overcome by additional infusion of glucose. This potentially confounding factor will have to be taken into account in planning future investigations of arginine-induced insulin secretion.
葡萄糖和精氨酸均为强效胰岛素促分泌剂，且能增强彼此的胰岛素分泌作用。我们研究了在禁食期间重复输注精氨酸是否会导致类似的胰岛素分泌，以及额外输注葡萄糖是否会在重复输注精氨酸期间改变胰岛素分泌模式。对6名正常人重复连续输注精氨酸（30分钟内输注0.3 g/kg），导致第三次输注期间第二阶段胰岛素分泌降低（p<0.05）。第三次输注前的刺激前血糖水平低于第一次输注前（p<0.05）。重复进行高血糖钳夹（30分钟内维持在17.5 mmol/l），三次输注期间胰岛素分泌相当。精氨酸和葡萄糖联合输注（高血糖钳夹）在第三次输注期间未导致分泌减少。我们首先得出结论，同时存在的高血糖会增强第二阶段胰岛素分泌；其次，长期禁食会导致胰腺B细胞适应性变化，导致精氨酸诱导的胰岛素分泌减少，而额外输注葡萄糖可克服这一现象。在规划未来关于精氨酸诱导胰岛素分泌的研究时，必须考虑到这一潜在的混杂因素。
