Copeland G P, Leinster S J, Davis J C, Hipkin L J
Department of Surgery, University of Liverpool, UK.
Br J Surg. 1987 Nov;74(11):1031-5. doi: 10.1002/bjs.1800741124.
The euglycaemic glucose clamp technique has been used to assess insulin resistance in patients with colorectal adenocarcinoma. Ten cancer patients were studied and compared with control subjects matched for age, sex and nutritional status. Forty-one euglycaemic clamps were performed at one of five different insulin infusion rates (20, 30, 40, 100 or 200 milliunits min-1 m-2). Glucose disposal was significantly decreased in the cancer group at all insulin infusion rates, whilst attained insulin levels and metabolic clearance rates of insulin were comparable in the control and cancer groups. Analysis of dose-response data allowed assessment of sensitivity (insulin concentration of half maximal glucose disposal) and responsiveness (maximal glucose disposal). Responsiveness was significantly reduced in the cancer group (40.3 versus 71.5 mumol kg-1 min-1; P less than 0.001), whilst sensitivity was similar (93.7 milliunits l-1 in controls versus 90.8 milliunits l-1 in cancer patients), suggesting a postreceptor defect in insulin action in the cancer group.
正常血糖葡萄糖钳夹技术已被用于评估结肠直肠癌患者的胰岛素抵抗。对10名癌症患者进行了研究，并与年龄、性别和营养状况相匹配的对照受试者进行了比较。以五种不同的胰岛素输注速率（20、30、40、100或200毫单位·分钟⁻¹·米⁻²）之一进行了41次正常血糖钳夹实验。在所有胰岛素输注速率下，癌症组的葡萄糖处置均显著降低，而对照组和癌症组的胰岛素达到水平和胰岛素代谢清除率相当。对剂量反应数据的分析允许评估敏感性（半数最大葡萄糖处置时的胰岛素浓度）和反应性（最大葡萄糖处置）。癌症组的反应性显著降低（40.3对71.5微摩尔·千克⁻¹·分钟⁻¹；P<0.001），而敏感性相似（对照组为93.7毫单位·升⁻¹，癌症患者为90.8毫单位·升⁻¹），这表明癌症组存在胰岛素作用的受体后缺陷。
