Miller L J, Malagelada J R, Go V L
J Clin Endocrinol Metab. 1978 Nov;47(5):1009-14. doi: 10.1210/jcem-47-5-1009.
The gastrointestinal contribution to carbohydrate metabolism includes carbohydrate absorption and the release of gastrointestinal hormones that interact with the endocrine pancreas. To learn the contributions to the enteroinsular axis from different levels of the gastrointestinal tract and different nutrients in chyme, we determined serum concentrations of glucose, gastric inhibitory peptide (GIP), insulin, and glucagon postprandially in six normal subjects who underwent diversion of chyme just proximal to an occlusive balloon at the ligament of Treitz and jejunal infusion of saline or chyme carbohydrate, protein, and lipid, separately or in combination. Postprandial elevations of serum glucose, GIP, and insulin and decrease of serum glucagon were elicited predominantly from the bowel and its contents distal to the ligament of Treitz. In this segment, each chyme nutrient (but especially carbohydrate) significantly stimulated factors affecting carbohydrate metabolism. Protein and lipid were able to block carbohydrate-induced glucagon inhibition. The gastroduodenal segment, although containing several proposed insulinotropic hormones (gastrin, secretin, and cholecystokinin), had no effect on serum glucose of glucagon and stimulated only small insulin and GIP responses.
胃肠道对碳水化合物代谢的作用包括碳水化合物吸收以及释放与胰腺内分泌相互作用的胃肠激素。为了了解胃肠道不同部位和食糜中不同营养物质对肠胰岛轴的作用，我们测定了6名正常受试者餐后血清葡萄糖、胃抑肽（GIP）、胰岛素和胰高血糖素的浓度。这些受试者在屈氏韧带处靠近阻塞球囊的近端使食糜改道，并分别或联合向空肠输注生理盐水或含有碳水化合物、蛋白质和脂质的食糜。餐后血清葡萄糖、GIP和胰岛素升高以及血清胰高血糖素降低主要源于屈氏韧带远端的肠道及其内容物。在该节段，每种食糜营养物质（尤其是碳水化合物）均显著刺激影响碳水化合物代谢的因子。蛋白质和脂质能够阻断碳水化合物诱导的胰高血糖素抑制作用。胃十二指肠段虽然含有几种推测的促胰岛素激素（胃泌素、促胰液素和胆囊收缩素），但对血清葡萄糖和胰高血糖素无影响，仅刺激产生较小的胰岛素和GIP反应。
