Perez G O, Rabinovitch A, Rietberg B, Owens B, Schiff E R
J Lab Clin Med. 1982 May;99(5):669-77.
The role of glucagon in the pathogenesis of abnormalities of glucose metabolism associated with renal failure remains undefined. We have evaluated glucagon-stimulated glucose and cyclic AMP output and amino acid uptake in isolated perfused livers of rats with experimentally-induced ARF and sham-operated controls. ARF animals exhibited azotemia, hyperglycemia, hyperinsulinemia, and hyperglucagonemia. During stimulation with physiologic (3 X 10-10M) or supraphysiologic (3 X 10-8M) glucagon concentrations, glucose output was lower in livers of ARF rats than in those of controls, whereas cyclic AMP responses were similar or exceeded those of controls. Hepatic glycogen content was lower in rats with ARF and the stores were exhausted at the end of perfusions. Additional studies in livers of fasted animals revealed no significant differences in glucose output or amino acid uptake between ARF and control livers perfused with physiologic levels of glucagon. These experiments suggest that the decreased glucagon-stimulated glucose output in isolated perfused livers in acutely uremic rats is due primarily to glycogen depletion rather than to impaired gluconeogenesis. Normal or increased cyclic AMP responses to glucagon suggests intactness of the hormone receptor-adenylate cyclase.
胰高血糖素在与肾衰竭相关的糖代谢异常发病机制中的作用仍不明确。我们评估了胰高血糖素刺激的葡萄糖和环磷酸腺苷(cAMP)输出以及氨基酸摄取情况,采用实验性诱导急性肾衰竭(ARF)大鼠和假手术对照组的离体灌注肝脏进行研究。ARF动物表现出氮质血症、高血糖、高胰岛素血症和高胰高血糖素血症。在用生理浓度(3×10⁻¹⁰M)或超生理浓度(3×10⁻⁸M)的胰高血糖素刺激期间,ARF大鼠肝脏的葡萄糖输出低于对照组,而环磷酸腺苷反应与对照组相似或超过对照组。ARF大鼠的肝糖原含量较低,且在灌注结束时糖原储备耗尽。对禁食动物肝脏的进一步研究表明,在灌注生理水平胰高血糖素的情况下,ARF肝脏和对照肝脏在葡萄糖输出或氨基酸摄取方面没有显著差异。这些实验表明,急性尿毒症大鼠离体灌注肝脏中胰高血糖素刺激的葡萄糖输出减少主要是由于糖原耗竭,而非糖异生受损。对胰高血糖素的环磷酸腺苷反应正常或增加表明激素受体 - 腺苷酸环化酶功能完整。