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胰岛素在血糖正常和低血糖期间对胆汁流动和脂质排泄的影响。

Insulin's effect on bile flow and lipid excretion during euglycemia and hypoglycemia.

作者信息

Jones R S, Putnam W, Andersen D K, Hanks J B, Lebovitz H E

出版信息

Dig Dis Sci. 1984 Jan;29(1):33-9. doi: 10.1007/BF01296859.

Abstract

Mongrel dogs were prepared by cholecystectomy, ligation of the lesser pancreatic duct, and insertion of modified Thomas cannulas into the stomach and duodenum. When the dogs had recovered from surgery, studies were performed on them, conscious and unanesthetized after an overnight fast. The common bile duct was catheterized through the opened duodenal cannula for collection of hepatic bile. Bile flow was stabilized by the intravenous infusion of sodium taurocholate. After 2 hr of taurocholate infusion, insulin was added to the infusion and continued for the duration of the experiment. Glucose was administered intravenously during the first 120 min of insulin administration to maintain euglycemia; then the glucose was discontinued. The intravenous infusion of insulin during euglycemia maintained by glucose infusion caused a significant increase in bile flow and a decrease in bile salt concentration, but no change in bile salt output. There was a decrease in cholesterol concentration and output and in phospholipid concentration, but no significant change in phospholipid output. When glucose infusion was discontinued and hypoglycemia occurred, there was a further significant increase in bile flow, but no other change. These studies demonstrate that the choleretic action of insulin is not dependent upon hypoglycemia and that intravenously administered insulin may cause increased bile secretion without increase in serum glucagon concentration. These experiments also confirm that insulin choleresis may be associated with a decline in cholesterol output.

摘要

杂种犬通过胆囊切除术、结扎胰小导管,并将改良的托马斯套管插入胃和十二指肠来制备。当犬从手术中恢复后,在禁食过夜后对其进行清醒且未麻醉状态下的研究。通过打开的十二指肠套管将胆总管插管以收集肝胆汁。通过静脉输注牛磺胆酸钠使胆汁流量稳定。在输注牛磺胆酸钠2小时后,将胰岛素加入输注液中并在实验期间持续输注。在胰岛素给药的前120分钟内静脉注射葡萄糖以维持血糖正常;然后停止输注葡萄糖。在通过葡萄糖输注维持血糖正常期间静脉输注胰岛素导致胆汁流量显著增加且胆汁盐浓度降低,但胆汁盐输出量无变化。胆固醇浓度和输出量以及磷脂浓度均降低,但磷脂输出量无显著变化。当停止葡萄糖输注并出现低血糖时,胆汁流量进一步显著增加,但无其他变化。这些研究表明胰岛素的利胆作用不依赖于低血糖,并且静脉注射胰岛素可能导致胆汁分泌增加而血清胰高血糖素浓度不升高。这些实验还证实胰岛素利胆作用可能与胆固醇输出量下降有关。

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