Smith-Laing G, Orskov H, Gore M B, Sherlock S
Diabetologia. 1980 Aug;19(2):103-8. doi: 10.1007/BF00421854.
Plasma glucagon and growth hormone concentrations were measured fasting and after oral glucose in 19 patients with portal vein block with extensive portal-systemic shunting but minimal liver cell damage, 11 cirrhotic patients and 12 matched control subjects. Portal vein block patients and controls had similar fasting glucose and glucagon levels (glucose 3.8 +/- 0.1 mmol/l VS control 3.4 +/- 0.1 mmol/l (mean +/- SEM); glucagon 57.5 +/- 9.1 pg/ml VS control 51.3 +/- 7.8 pg/ml). Cirrhotic patients were hyperglycaemic (cirrhosis 4.3 +/- 0.2 mmol/l VS control 3.4 +/- 0.1 mmol/l, p < 0.01) with significantly elevated glucagon levels (167.3 +/- 61.1 pg/ml VS control 51.3 +/- 7.8 pg/ml, p < 0.05), which suppressed towards control values after oral glucose. There was no correlation between fasting plasma glucagon levels and the degree of portal-systemic shunting in cirrhotic patients. There was a strong correlation between fasting plasma glucagon concentrations and aspartate transaminase levels (r = 0.68; p < 0.01) in cirrhotic and portal vein block patients. Significant elevations of growth hormone were seen only in cirrhotic patients. It is concluded that hyperglucagonaemia is a feature of hepatocellular damage rather than portal-systemic shunting but the relationship between elevated glucagon and growth hormone concentrations and carbohydrate intolerance in cirrhosis remains unclear.
对19例门静脉阻塞伴广泛门体分流但肝细胞损伤轻微的患者、11例肝硬化患者和12例匹配的对照者，分别在空腹及口服葡萄糖后测定血浆胰高血糖素和生长激素浓度。门静脉阻塞患者和对照者的空腹血糖和胰高血糖素水平相似（血糖3.8±0.1 mmol/L对对照者3.4±0.1 mmol/L（均值±标准误）；胰高血糖素57.5±9.1 pg/ml对对照者51.3±7.8 pg/ml）。肝硬化患者血糖升高（肝硬化患者4.3±0.2 mmol/L对对照者3.4±0.1 mmol/L，p<0.01），胰高血糖素水平显著升高（167.3±61.1 pg/ml对对照者51.3±7.8 pg/ml，p<0.05），口服葡萄糖后向对照值下降。肝硬化患者空腹血浆胰高血糖素水平与门体分流程度无相关性。肝硬化患者和门静脉阻塞患者空腹血浆胰高血糖素浓度与天冬氨酸转氨酶水平之间存在强相关性（r = 0.68；p<0.01）。仅在肝硬化患者中观察到生长激素显著升高。结论是，高胰高血糖素血症是肝细胞损伤的特征而非门体分流，但肝硬化患者胰高血糖素和生长激素浓度升高与碳水化合物不耐受之间的关系仍不清楚。
