Cherrington A D, Lacy W W, Chiasson J L
J Clin Invest. 1978 Sep;62(3):664-77. doi: 10.1172/JCI109174.
The aim of the present experiments was to determine the effects of basal glucagon on glucose production after induction of prolonged insulin lack in normal conscious dogs fasted overnight. A selective deficiency of insulin or a combined deficiency of both pancreatic hormones was created by infusing somatostatin alone or in combination with an intraportal replacement infusion of glucagon. Glucose production (GP) was measured by a primed constant infusion of [3H-3]glucose, and gluconeogenesis (GNG) was assessed by determining the conversion rate of circulating [14C]alanine and [14C]lactate into [14C]glucose. When insulin deficiency was induced in the presence of basal glucagon the latter hormone caused GP to double and then to decline so that after 4 h it had returned to the conrol rate. The conversion of alanine and lactate into glucose, on the other hand, increased throughout the period of insulin lack. Withdrawal of glucagon after GP had normalized resulted in a 40% fall in GP, a 37% decrease in GNG, and a marked decrease in the plasma glucose concentration. Induction of insulin deficiency in the absence of basal glucagon resulted in an initial (30%) drop in GP followed by a restoration of normal GP after 2--3 h and moderately enhanced glucose formation from alanine and lactate. It can be concluded that (a) the effect of relative hyperglucagonemia on GP is short-lived; (b) the waning of the effect of glucagon is attributable solely to a diminution of glycogenolysis because GNG remains stimulated; (c) basal glucagon markedly enhances the GNG stimulation apparent after induction of insulin deficiency; and (d) basal glucagon worsens the hyperglycemia pursuant on the induction of insulin deficiency both by triggering an initial overproduction of glucose and by maintaining the basal production rate thereafter.
本实验的目的是确定基础胰高血糖素对正常清醒且禁食过夜的犬长时间胰岛素缺乏诱导后葡萄糖生成的影响。通过单独输注生长抑素或与门静脉内补充输注胰高血糖素联合使用,造成胰岛素选择性缺乏或两种胰腺激素联合缺乏。通过对[3H-3]葡萄糖进行初始恒速输注来测量葡萄糖生成(GP),并通过测定循环中的[14C]丙氨酸和[14C]乳酸转化为[14C]葡萄糖的转化率来评估糖异生(GNG)。当在基础胰高血糖素存在的情况下诱导胰岛素缺乏时,后一种激素会使GP翻倍,然后下降,以至于4小时后它已恢复到对照速率。另一方面,在整个胰岛素缺乏期间,丙氨酸和乳酸向葡萄糖的转化增加。在GP恢复正常后停用胰高血糖素导致GP下降40%,GNG下降37%,血浆葡萄糖浓度显著降低。在没有基础胰高血糖素的情况下诱导胰岛素缺乏导致GP最初下降(30%),随后在2 - 3小时后恢复正常GP,并适度增强了丙氨酸和乳酸生成葡萄糖的过程。可以得出以下结论:(a)相对高胰高血糖素血症对GP的影响是短暂的;(b)胰高血糖素作用的减弱完全归因于糖原分解的减少,因为GNG仍受到刺激;(c)基础胰高血糖素显著增强了胰岛素缺乏诱导后明显的GNG刺激;(d)基础胰高血糖素通过引发最初的葡萄糖过度生成并在此后维持基础生成速率,使胰岛素缺乏诱导后的高血糖症恶化。