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血糖增强作用的降低。部分胰腺切除犬β细胞丢失的敏感指标。

Reduction of glycemic potentiation. Sensitive indicator of beta-cell loss in partially pancreatectomized dogs.

作者信息

Ward W K, Wallum B J, Beard J C, Taborsky G J, Porte D

机构信息

Department of Medicine, University of Washington, Seattle.

出版信息

Diabetes. 1988 Jun;37(6):723-9. doi: 10.2337/diab.37.6.723.

Abstract

To determine which test of islet function is the most sensitive indicator of subclinical beta-cell loss, we studied six conscious dogs before and 1 and 6 wk after removal of the splenic and uncinate lobes [64 +/- 2% pancreatectomy (PX)]. To assess hyperglycemic potentiation, acute insulin secretory responses (AIR) to 5 g i.v. arginine were measured at the fasting plasma glucose (FPG) level after PG was clamped at approximately 250 mg/dl and after PG was clamped at a maximally potentiating level of 550-650 mg/dl. FPG levels were unaffected by PX (112 +/- 4 mg/dl pre-PX vs. 115 +/- 5 mg/dl 6 wk after PX, P NS). Similarly, basal insulin levels remained constant after PX (11 +/- 2 microU/ml pre-PX vs. 11 +/- 1 microU/ml 6 wk after PX, P NS). The AIR to 300 mg/kg i.v. glucose decreased slightly from 42 +/- 9 microU/ml pre-PX to 32 +/- 5 microU/ml 6 wk after PX (P NS), and thus the beta-cell loss was underestimated. In contrast, insulin responses to arginine declined markedly after PX. The AIR to arginine obtained at FPG levels declined from 23 +/- 3 microU/ml pre-PX to 13 +/- 2 microU/ml 6 wk after PX (P = .04). The AIR to arginine obtained at PG levels of approximately 250 mg/dl declined even more, from a pre-PX value of 56 +/- 7 microU/ml to 21 +/- 4 microU/ml 6 wk after PX (P = .02).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为了确定哪种胰岛功能测试是亚临床β细胞丢失的最敏感指标,我们在6只清醒犬切除脾叶和钩突叶(胰腺切除术64±2%)之前以及术后1周和6周进行了研究。为评估高血糖增强作用,在将血糖钳夹在约250mg/dl的空腹血糖(FPG)水平以及钳夹在最大增强水平550 - 650mg/dl后,测量对5g静脉注射精氨酸的急性胰岛素分泌反应(AIR)。FPG水平不受胰腺切除术影响(术前112±4mg/dl vs. 术后6周115±5mg/dl,P无显著性差异)。同样,基础胰岛素水平在胰腺切除术后保持恒定(术前11±2μU/ml vs. 术后6周11±1μU/ml,P无显著性差异)。对300mg/kg静脉注射葡萄糖的AIR从术前的42±9μU/ml略有下降至术后6周的32±5μU/ml(P无显著性差异),因此β细胞丢失被低估。相比之下,胰腺切除术后对精氨酸的胰岛素反应明显下降。在FPG水平获得的对精氨酸的AIR从术前的23±3μU/ml下降至术后6周的13±2μU/ml(P = 0.04)。在血糖水平约250mg/dl时获得的对精氨酸的AIR下降得更多,从术前值56±7μU/ml降至术后6周的21±4μU/ml(P = 0.02)。(摘要截短至250字)

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