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在肾上腺切除的犬中研究皮质醇与肾上腺素相互作用的血糖调节作用。

Glucoregulatory role of cortisol and epinephrine interactions studied in adrenalectomized dogs.

作者信息

Gauthier C, el-Tayeb K, Vranic M, Lickley H L

出版信息

Am J Physiol. 1986 Apr;250(4 Pt 1):E393-401. doi: 10.1152/ajpendo.1986.250.4.E393.

Abstract

The importance of basal cortisol (H) and epinephrine (E) levels on glucoregulation, and the effects of E, given to simulate moderate to severe stress (5 times basal rate of infusion), were examined in seven conscious adrenalectomized dogs. Although plasma glucagon (IRG) increased by 47%, insulin (IRI) decreased by 36%, norepinephrine (NE) increased by 103%, and FFA decreased by 26%, glucose concentration and kinetics remained normal after adrenalectomy. A 4-h infusion of H reestablished basal cortisol levels and returned IRG to its basal preadrenalectomy level with no change in IRI, NE, and FFA levels. Glucose production and metabolic clearance decreased concomitantly by 20%, maintaining euglycemia. A 90-min infusion of basal E caused only a transient increase in IRG. The simultaneous infusion of H with E prevented this increase in IRG and returned IRI to preadrenalectomy levels in the absence of any change in NE or glucose. A subsequent infusion of five times basal E, alone, raised circulating E levels and caused a transient decrease in plasma NE, but no change in IRI. There was a similar hyperglycemic response, as seen previously in normal dogs. The simultaneous infusion of H and E prevented the decrease in NE, but did not change the IRI and FFA responses. There was an 80% greater plasma glucose response than seen during infusion of E alone. In conclusion, what E and H lack after adrenalectomy is compensated for by an increase in IRG and a decrease in IRI, and normal glucose concentrations and kinetics are maintained. It appeared that normoglucagonemia required basal H release, whereas normoinsulinemia required both basal H and E secretion.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在七只清醒的肾上腺切除犬中,研究了基础皮质醇(H)和肾上腺素(E)水平对葡萄糖调节的重要性,以及给予E以模拟中度至重度应激(基础输注速率的5倍)的影响。尽管血浆胰高血糖素(IRG)增加了47%,胰岛素(IRI)降低了36%,去甲肾上腺素(NE)增加了103%,游离脂肪酸(FFA)降低了26%,但肾上腺切除术后血糖浓度和动力学仍保持正常。4小时输注H可恢复基础皮质醇水平,并使IRG恢复到肾上腺切除术前的基础水平,而IRI、NE和FFA水平无变化。葡萄糖生成和代谢清除率同时降低20%,维持血糖正常。输注基础E 90分钟仅导致IRG短暂升高。同时输注H和E可防止IRG升高,并使IRI在NE或葡萄糖无任何变化的情况下恢复到肾上腺切除术前水平。随后单独输注5倍基础量的E可提高循环E水平,并导致血浆NE短暂降低,但IRI无变化。出现了与之前正常犬相似的高血糖反应。同时输注H和E可防止NE降低,但不改变IRI和FFA反应。血浆葡萄糖反应比单独输注E时高80%。总之,肾上腺切除术后E和H缺乏的情况可通过IRG增加和IRI降低得到补偿,并维持正常的葡萄糖浓度和动力学。似乎正常胰高血糖素血症需要基础H释放,而正常胰岛素血症需要基础H和E分泌。(摘要截取自250字)

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