Duke Molecular Physiology Institute and.
Department of Medicine, Duke University, Durham, North Carolina, USA.
JCI Insight. 2019 Jul 23;5(16):129954. doi: 10.1172/jci.insight.129954.
Glucagon and insulin are commonly believed to have counteracting effects on blood glucose levels. However, recent studies have demonstrated that glucagon has a physiologic role to activate β-cells and enhance insulin secretion. To date, the actions of glucagon have been studied mostly in fasting or hypoglycemic states, yet it is clear that mixed-nutrient meals elicit secretion of both glucagon and insulin, suggesting that glucagon also contributes to glucose regulation in the postprandial state. We hypothesized that the elevated glycemia seen in the fed state would allow glucagon to stimulate insulin secretion and reduce blood glucose. In fact, exogenous glucagon given under fed conditions did robustly stimulate insulin secretion and lower glycemia. Exogenous glucagon given to fed Gcgr:Glp1rβcell-/- mice failed to stimulate insulin secretion or reduce glycemia, demonstrating the importance of an insulinotropic glucagon effect. The action of endogenous glucagon to reduce glycemia in the fed state was tested with administration of alanine, a potent glucagon secretagogue. Alanine raised blood glucose in fasted WT mice or fed Gcgr:Glp1rβcell-/- mice, conditions where glucagon is unable to stimulate β-cell activity. However, alanine given to fed WT mice produced a decrease in glycemia, along with elevated insulin and glucagon levels. Overall, our data support a model in which glucagon serves as an insulinotropic hormone in the fed state and complements rather than opposes insulin action to maintain euglycemia.
人们普遍认为胰高血糖素和胰岛素对血糖水平有拮抗作用。然而,最近的研究表明,胰高血糖素有激活β细胞和增强胰岛素分泌的生理作用。迄今为止,人们对胰高血糖素的作用主要在禁食或低血糖状态下进行了研究,但很明显,混合营养餐后会同时引发胰高血糖素和胰岛素的分泌,这表明胰高血糖素在餐后状态下也有助于血糖调节。我们假设进食状态下升高的血糖水平将允许胰高血糖素刺激胰岛素分泌并降低血糖。事实上,在进食条件下给予外源性胰高血糖素确实可以强烈刺激胰岛素分泌并降低血糖。在喂食的 Gcgr:Glp1rβcell-/- 小鼠中给予外源性胰高血糖素未能刺激胰岛素分泌或降低血糖,这表明了胰岛素促胰高血糖素效应的重要性。通过给予丙氨酸(一种有效的胰高血糖素分泌激动剂)来测试内源性胰高血糖素在进食状态下降低血糖的作用。丙氨酸会升高禁食 WT 小鼠或喂食 Gcgr:Glp1rβcell-/- 小鼠的血糖,在这些条件下,胰高血糖素无法刺激β细胞活性。然而,给予喂食的 WT 小鼠丙氨酸会导致血糖降低,同时胰岛素和胰高血糖素水平升高。总的来说,我们的数据支持这样一种模型,即胰高血糖素在进食状态下作为一种胰岛素促分泌激素,与胰岛素协同作用而不是拮抗作用来维持血糖正常。