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钙和降钙素对糖尿病患者胰高血糖素和血糖循环水平的影响。

Effects of calcium and calcitonin on circulating levels of glucagon and glucose in diabetes mellitus.

作者信息

Starke A, Keck E, Berger M, Zimmermann H

出版信息

Diabetologia. 1981 May;20(5):547-52. doi: 10.1007/BF00252763.

Abstract

The effects of Ca2+ and calcitonin infusions on circulating glucagon, glucose, C-peptide, Ca2+, and calcitonin were investigated in hyper-glucagonaemic insulin-dependent diabetics. In 14 insulin-deprived diabetics and 12 healthy volunteers 2h infusions of saline (0.154 mol/1), Ca2+ (0.375 mmol/kg body weight), and calcitonin (4.5 IU/kg body weight) were performed. There were no significant changes during saline infusion. In the diabetics, Ca2+ infusions induced a rise of plasma Ca2+ up to 3.2 +/- 0.1 mmol/1 and a fall of circulating glucagon (-26.4 +/- 5.7%; p less than 0.001) and glucose (-23.3 +/- 3.6%; p less than 0.05). Plasma calcitonin rose to twice basal values (p less than 0.025). During calcitonin infusions plasma Ca2+ decreased slightly to 2.1 +/- 0.2 mmol/1; a fall was found in both glucose (-24.4 +/- 4.0%; p less than 0.05) and circulating glucagon (-22.5 +/- 4.3%; p less than 0.001). Two groups of 6 healthy volunteers were subjected to saline and Ca2+, or to Ca2+ and calcitonin infusions. Both Ca2+ and calcitonin infusions induced a fall of serum insulin (-30.1 +/- 6.6%; p less than 0.05). Calcitonin depressed circulating glucagon by -18.6 +/- 4.4% (p less than 0.025), whereas during Ca2+ infusions glucagon decreased only by -6.5 +/- 1.9% (p greater than 0.1). We conclude from our results that an increase of circulating calcitonin induced by Ca2+ infusions or by exogenous calcitonin administration appears to depress elevated circulating glucagon and glucose in insulin-dependent diabetics.

摘要

在高胰高血糖素血症的胰岛素依赖型糖尿病患者中,研究了输注钙离子和降钙素对循环中的胰高血糖素、葡萄糖、C肽、钙离子及降钙素的影响。对14名胰岛素缺乏的糖尿病患者和12名健康志愿者进行了2小时的生理盐水(0.154 mol/1)、钙离子(0.375 mmol/kg体重)及降钙素(4.5 IU/kg体重)输注。输注生理盐水期间无显著变化。在糖尿病患者中,输注钙离子使血浆钙离子升高至3.2±0.1 mmol/1,循环中的胰高血糖素降低(-26.4±5.7%;p<0.001),葡萄糖降低(-23.3±3.6%;p<0.05)。血浆降钙素升至基础值的两倍(p<0.025)。输注降钙素期间,血浆钙离子略有下降至2.1±0.2 mmol/1;葡萄糖(-24.4±4.0%;p<0.05)和循环中的胰高血糖素(-22.5±4.3%;p<0.001)均下降。两组各6名健康志愿者分别接受生理盐水和钙离子输注,或钙离子与降钙素输注。钙离子和降钙素输注均导致血清胰岛素下降(-30.1±6.6%;p<0.05)。降钙素使循环中的胰高血糖素降低-18.6±4.4%(p<0.025),而输注钙离子期间胰高血糖素仅降低-6.5±1.9%(p>0.1)。我们从结果中得出结论,钙离子输注或外源性给予降钙素引起的循环降钙素增加似乎可降低胰岛素依赖型糖尿病患者升高的循环胰高血糖素和葡萄糖水平。

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