Barnes A J, Bloom S R
Lancet. 1976 Jan 31;1(7953):219-21. doi: 10.1016/s0140-6736(76)91339-8.
The proposition that glucagon plays an essential part in maintaining hyperglycaemia in diabetes has been investigated by the study of 5 totally pancreatectomised subjects and 5 age and sex matched insulin-dependent diabetic patients. True basal glucagon values were obtained by the use of a new affinity chromatography technique. The mean fasting plasma-glucose levels of the pancreatectomised subjects was 251 +/- 46 mg/dl. The mean fasting plasma-glucagon level was not significantly elevated above zero (1-3 +/- 0-6 pmol/l) and showed no change following arginine. In the 5 insulin-dependent diabetics the mean fasting plasma-glucagon level of 17-2 +/- 5-3 pmol/l rose to a maximum at 25 minutes of 103-6 +/- 27-5 pmol/l during infusion of arginine. These findings imply the absence of a significant number of normally functioning alpha cells in extrapancreatic sites in man and demonstrate that pronounced hyperglycaemia may occur in the absence of glucagon. Glucagon is probably not of primary importance in the hyperglycaemia of insulin-dependent diabetics.
通过对5名全胰腺切除患者以及5名年龄和性别匹配的胰岛素依赖型糖尿病患者的研究，对胰高血糖素在糖尿病患者维持高血糖过程中起关键作用这一命题进行了调查。采用一种新的亲和色谱技术获得了真实的基础胰高血糖素值。全胰腺切除患者的空腹血浆葡萄糖平均水平为251±46mg/dl。空腹血浆胰高血糖素平均水平未显著高于零（1.3±0.6pmol/l），且注射精氨酸后无变化。在5名胰岛素依赖型糖尿病患者中，空腹血浆胰高血糖素平均水平为17.2±5.3pmol/l，在注射精氨酸期间，25分钟时升至最高值103.6±27.5pmol/l。这些发现表明人体胰腺外部位不存在大量正常功能的α细胞，并证明在没有胰高血糖素的情况下可能会出现明显的高血糖。胰高血糖素在胰岛素依赖型糖尿病患者的高血糖症中可能并非至关重要。
