Nankervis A, Proietto J, Ng K W, Alford F P, Larkins R
Clin Endocrinol (Oxf). 1981 Oct;15(4):325-33. doi: 10.1111/j.1365-2265.1981.tb00672.x.
A subject with a benign glucagonoma was studied before and after complete resection of his pancreatic tumour. Studies were undertaken pre- and post-operatively to determine the effects of chronic hyperglucagonaemia on glucose tolerance and glucose kinetics both in the fasting state and during physiological insulin infusions, employing the [3H]-3-glucose technique. In addition the plasma cyclic AMP response to an acute infusion of glucagon was studied pre- and post-operatively. The basal immunoreactive glucagon levels pre- and post-operatively were 10492 +/- 1296 and 149 +/- 15 pg/ml respectively. Pre- and post-operative oral glucose tolerance tests did not differ but were abnormal. Pre-operatively basal hepatic glucose production was normal and it was suppressed rapidly by the low dose insulin infusion, despite continuing hyperglucagonaemia. The metabolic clearance rate of glucose was slightly reduced. There was no plasma cyclic AMP response to a glucagon infusion, suggesting down-regulation of the glucagon receptor by the chronic hyperglucagonaemia. Post-operatively the hepatic glucose production and clearance rate of glucose fell, whereas the plasma cyclic AMP responses to the glucagon infusion reverted to a normal pattern. It is concluded that chronic hyperglucagonaemia is not a major factor in the development of the glucose intolerance, but it may lead to down-regulation of the biological action of glucagon.
对一名患有良性胰高血糖素瘤的患者在胰腺肿瘤完全切除前后进行了研究。采用[3H]-3-葡萄糖技术，在术前和术后进行了研究，以确定慢性高胰高血糖素血症在禁食状态和生理性胰岛素输注期间对葡萄糖耐量和葡萄糖动力学的影响。此外，还在术前和术后研究了急性输注胰高血糖素后血浆环磷酸腺苷的反应。术前和术后基础免疫反应性胰高血糖素水平分别为10492±1296和149±15 pg/ml。术前和术后口服葡萄糖耐量试验无差异，但均异常。术前基础肝葡萄糖生成正常，尽管持续存在高胰高血糖素血症，但低剂量胰岛素输注可迅速抑制肝葡萄糖生成。葡萄糖的代谢清除率略有降低。对胰高血糖素输注无血浆环磷酸腺苷反应，提示慢性高胰高血糖素血症使胰高血糖素受体下调。术后肝葡萄糖生成和葡萄糖清除率下降，而对胰高血糖素输注的血浆环磷酸腺苷反应恢复正常模式。结论是，慢性高胰高血糖素血症不是葡萄糖不耐受发生的主要因素，但可能导致胰高血糖素生物作用的下调。
