Gerich J E, Lorenzi M, Bier D M, Tsalikian E, Schneider V, Karam J H, Forsham P H
J Clin Invest. 1976 Apr;57(4):875-84. doi: 10.1172/JCI108364.
To study the individual effects of glucagon and growth hormone on human carbohydrate and lipid metabolism, endogenous secretion of both hormones was simultaneously suppressed with somatostatin and physiologic circulating levels of one or the other hormone were reproduced by exogenous infusion. The interaction of these hormones with insulin was evaluated by performing these studies in juvenile-onset, insulin-deficient diabetic subjects both during infusion of insulin and after its withdrawal. Infusion of glucagon (1 ng/kg-min) during suppression of its endogenous secretion with somatostatin produced circulating hormone levels of approximately 200 pg/ml. When glucagon was infused along with insulin, plasma glucose levels rose from 94 +/- 8 to 126 +/- 12 mg/100 ml over 1 h (P less than 0.01); growth hormone, beta-hydroxy-butyrate, alanine, FFA, and glycerol levels did not change. When insulin was withdrawn, plasma glucose, beta-hydroxybutyrate, FFA, and glycerol all rose to higher levels (P less than 0.01) than those observed under similar conditions when somatostatin alone had been infused to suppress glucagon secretion. Thus, under appropriate conditions, physiologic levels of glucagon can stimulate lipolysis and cause hyperketonemia and hyperglycemia in man; insulin antagonizes the lipolytic and ketogenic effects of glucagon more effectively than the hyperglycemic effect. Infusion of growth hormone (1 mug/kg-h) during suppression of its endogenous secretion with somastostatin produced circulating hormone levels of approximately 6 ng/ml. When growth hormone was administered along with insulin, no effects were observed. After insulin was withdrawn, plasma beta-hydroxybutyrate, glycerol, and FFA all rose to higher levels (P less than 0.01) than those observed during infusion of somatostatin alone when growth hormone secretion was suppressed; no difference in plasma glucose, alanine, and glucagon levels was evident. Thus, under appropriate conditions, physiologic levels of growth hormone can augment lipolysis and ketonemia in man, but these actions are ordinarily not apparent in the presence of physiologic levels of insulin.
为研究胰高血糖素和生长激素对人体碳水化合物及脂质代谢的个体效应，用生长抑素同时抑制这两种激素的内源性分泌，并通过外源性输注重现其中一种激素的生理循环水平。在青少年发病型胰岛素缺乏糖尿病患者中，于输注胰岛素期间及停药后进行这些研究，以评估这些激素与胰岛素的相互作用。在用生长抑素抑制胰高血糖素内源性分泌期间输注胰高血糖素（1纳克/千克·分钟），可使循环激素水平达到约200皮克/毫升。当胰高血糖素与胰岛素同时输注时，血浆葡萄糖水平在1小时内从94±8毫克/100毫升升至126±12毫克/100毫升（P＜0.01）；生长激素、β-羟基丁酸、丙氨酸、游离脂肪酸（FFA）和甘油水平未发生变化。当停用胰岛素后，血浆葡萄糖、β-羟基丁酸、FFA和甘油均升至比单独输注生长抑素抑制胰高血糖素分泌时在类似条件下所观察到的水平更高的水平（P＜0.01）。因此，在适当条件下，生理水平的胰高血糖素可刺激人体脂肪分解并导致高酮血症和高血糖症；胰岛素对胰高血糖素的脂肪分解和生酮作用的拮抗作用比对高血糖作用的拮抗作用更有效。在用生长抑素抑制生长激素内源性分泌期间输注生长激素（1微克/千克·小时），可使循环激素水平达到约6纳克/毫升。当生长激素与胰岛素同时给药时，未观察到任何效应。停用胰岛素后，血浆β-羟基丁酸、甘油和FFA均升至比单独输注生长抑素抑制生长激素分泌时所观察到的水平更高的水平（P＜0.01）；血浆葡萄糖、丙氨酸和胰高血糖素水平无明显差异。因此，在适当条件下，生理水平的生长激素可增强人体脂肪分解和酮血症，但这些作用在生理水平的胰岛素存在时通常并不明显。
