Popa M, Simionescu L, Dumitriu E, Dimitriu V, Giurcãneanu M, Bartoc R, Dinulescu E
C. I. Parhon, Institute of Endocrinology, Bucharest, Romania.
Endocrinologie. 1987 Jul-Sep;25(3):149-55.
Assuming that the serum-to-saliva transfer of insulin reflects internalization and re-cycling of the hormone in the membrane-located binding sites of salivary epithelial cells and that these cells have in obesity a'marked decrease in insulin receptor content, it has been postulated that insulin resistance in infantile obesity can be detected by the changes in the salivary immunoreactive insulin during the oral glucose tolerance test (OGTT). The study included 31 obese children and adolescents of both sexes, subjected to OGTT. Samples of blood and saliva were collected at 30, 60, 120, 180 and 240 minutes for determinations of glucose and IRI. The blood glucose values were generally normal whereas IRI was excessively high. The dynamics of salivary IRI was similar (easy peak followed by slow descent) with the mean serum values but lower by about two-thirds, and the peak was 30-60 minutes delayed. The serum IRI values correlated significantly with the saliva ones at all time-intervals except for the 30-minute ones. The serum IRI values were significantly lower at the 30-minute time interval, whereas the salivary IRI were the lowest (and of borderline significance) at the 60-min. time interval. The mean glucose/kg doses given orally were not significantly different in the two groups. It was concluded that a hormonal activity detectable by IRI assay through the PEG separation method does exist, with a concomitant variation of serum-to-saliva transfer as shown by the OGTT test. It was also concluded that since the salivary values are lower, the direction of the flow is from serum to saliva and not the reverse. Finally, on the basis of our data, an "in situ" synthesis of insulin (hormonogenic exocrinism) can not be ruled out.
假设胰岛素从血清到唾液的转移反映了该激素在唾液上皮细胞膜结合位点的内化和再循环，且肥胖时这些细胞的胰岛素受体含量“显著降低”，因此推测婴儿肥胖中的胰岛素抵抗可通过口服葡萄糖耐量试验（OGTT）期间唾液免疫反应性胰岛素的变化来检测。该研究纳入了31名肥胖儿童和青少年（男女均有），对其进行OGTT。在30、60、120、180和240分钟采集血液和唾液样本，以测定葡萄糖和免疫反应性胰岛素（IRI）。血糖值一般正常，而IRI过高。唾液IRI的动态变化与血清平均值相似（先快速达到峰值，随后缓慢下降），但约低三分之二，且峰值延迟30 - 60分钟。除30分钟时外，血清IRI值在所有时间间隔均与唾液IRI值显著相关。血清IRI值在30分钟时间间隔时显著较低，而唾液IRI在60分钟时间间隔时最低（且具有临界显著性）。两组口服的平均葡萄糖/千克剂量无显著差异。得出的结论是，通过聚乙二醇分离法的IRI测定可检测到一种激素活性，OGTT试验显示血清到唾液的转移存在相应变化。还得出结论，由于唾液值较低，流动方向是从血清到唾液，而非相反。最后，根据我们的数据，不能排除胰岛素的“原位”合成（激素生成性外分泌）。
