Rizza R A, Gerich J E
J Clin Endocrinol Metab. 1979 Feb;48(2):352-5. doi: 10.1210/jcem-48-2-352.
In man prolonged infusions of glucagon cause a transient increase in glucose production. To determine whether this represents complete loss of effect of hyperglucagonemia on the liver or merely decreased hepatic responsiveness, glucagon (3 ng/kg/min) was infused in six normal subjects to produce sustained hyperglucagonemia for 180 min; at this time glucagon infusions were stopped for 60 min, then restarted at the same rate for 60 min and finally increased to 7.5 ng/kg/min for 30 min. Glucose production (Ra) and utilization (Rd) were measured isotopically. Initially glucagon infusion increased Ra transiently from 1.8 +/- 0.1 mg/kg/min to a maximum at 15 min of 2.5 +/- 0.2 mg/kg/min (p less than .01); Ra returned to basal values by 60 min and remained there until the glucagon infusion was stopped, whereupon it abruptly declined to a nadir of 1.4 +/- 0.1 mg/kg/min, a value significantly below baseline levels, p less than .005. Upon restarting the glucagon infusion, Ra increased to a similar extent as observed with the initial infusion and then returned to basal levels; when the glucagon infusion rate was increased to 7.5 ng/kg/min, Ra again increased. These results indicate that sustained hyperglucagonemia, despite apparent waning of its effect, continues to modulate hepatic glucose production.
在人体中,长时间输注胰高血糖素会导致葡萄糖生成出现短暂增加。为了确定这是高胰高血糖素血症对肝脏的作用完全丧失,还是仅仅是肝脏反应性降低,对6名正常受试者输注胰高血糖素(3纳克/千克/分钟),以产生持续180分钟的高胰高血糖素血症;此时停止输注胰高血糖素60分钟,然后以相同速率重新开始输注60分钟,最后将输注速率提高到7.5纳克/千克/分钟,持续30分钟。采用同位素法测量葡萄糖生成率(Ra)和利用率(Rd)。最初输注胰高血糖素时,Ra从1.8±0.1毫克/千克/分钟短暂增加,在15分钟时达到最大值2.5±0.2毫克/千克/分钟(p<0.01);到60分钟时Ra恢复到基础值,并一直保持到停止输注胰高血糖素,此时它突然降至最低点1.4±0.1毫克/千克/分钟,该值显著低于基线水平,p<0.005。重新开始输注胰高血糖素后,Ra增加的幅度与最初输注时相似,然后又恢复到基础水平;当胰高血糖素输注速率提高到7.5纳克/千克/分钟时,Ra再次增加。这些结果表明,尽管持续高胰高血糖素血症的作用明显减弱,但它仍继续调节肝脏葡萄糖生成。