Tamura K, Kajiwara T, Suzuki T, Tobe T
Diabetes. 1978 Dec;27(12):1156-66. doi: 10.2337/diab.27.12.1156.
Functional alteration of the islet cells was investigated in dogs after the resection of different parts of the small intestine. Three weeks after jejunal or ileal resection, when the dogs might still have been in a catabolic state, insulin and pancreatic glucagon release in response to intravenously infused glucose and arginine was reduced. Three months after jejunal resection, both intravenous glucose tolerance and insulinogenic index in the intravenous glucose tolerance test were significantly below the preoperative values (P less than 0.001, P less than 0.05), while pancreatic glucagon release in response to arginine infusion release. This functional alteration three months after jejunal resection was similar to that seen in diabetes mellitus. On the other hand, three months after ileal resection, insulin and pancreatic glucagon release was almost normal. We conclude that the jejunum plays a more important role in the enteroinsular system than the ileum and that prolonged interruption of this enteroinsular axis can cause insular disorder and what could hypothetically be called enterogenic chemical diabetes, in view of the altered glucose tolerance test and the alteration in insulin secretory response.
在犬类中，研究了小肠不同部位切除术后胰岛细胞的功能改变。空肠或回肠切除术后三周，此时犬类可能仍处于分解代谢状态，静脉输注葡萄糖和精氨酸后胰岛素和胰高血糖素的释放减少。空肠切除术后三个月，静脉葡萄糖耐量试验中的静脉葡萄糖耐量和胰岛素生成指数均显著低于术前值（P<0.001，P<0.05），而静脉输注精氨酸后胰高血糖素释放。空肠切除术后三个月的这种功能改变与糖尿病中所见相似。另一方面，回肠切除术后三个月，胰岛素和胰高血糖素释放几乎正常。我们得出结论，空肠在肠胰岛系统中比回肠发挥更重要的作用，并且鉴于葡萄糖耐量试验改变和胰岛素分泌反应改变，这种肠胰岛轴的长期中断可导致胰岛紊乱以及理论上可称为肠源性化学性糖尿病的情况。
