Shmueli E, Orskov H, Alberti K G, Record C O
Department of Medicine, Royal Victoria Infirmary, Newcastle Upon Tyne, England.
Horm Metab Res. 1993 Jun;25(6):317-20. doi: 10.1055/s-2007-1002108.
Forearm glucose uptake during a hyperglycaemic (10 mmol/l) glucose clamp was diminished to 33% of the normal value (p = 0.012) in six cirrhotic patients compared with matched control subjects. Fasting insulin concentrations were significantly elevated in the cirrhotic patients confirming insulin resistance which may have been induced by chronic hyperinsulinaemia. The cirrhotic patients received one week of treatment with 50 micrograms octreotide subcutaneously three times daily which reduced pre-dose fasting insulin levels from 26.2 +/- 7.9 to 18.1 +/- 6.2 mU/l p < 0.005, and post dose levels to 7.0 +/- 3.5 mU/l p < 0.005. However when the glucose clamp was repeated 20 hours after the last dose of octreotide no change was detected in clamp glucose requirements, forearm glucose uptake, or stimulated insulin secretion. It was concluded that one week of lowering insulin levels does not reverse the insulin resistance of cirrhosis.
与匹配的对照受试者相比，6例肝硬化患者在高血糖（10 mmol/l）葡萄糖钳夹期间的前臂葡萄糖摄取减少至正常值的33%（p = 0.012）。肝硬化患者的空腹胰岛素浓度显著升高，证实存在胰岛素抵抗，这可能是由慢性高胰岛素血症诱导的。肝硬化患者接受了为期一周的治疗，每天皮下注射50微克奥曲肽3次，这使给药前空腹胰岛素水平从26.2±7.9降至18.1±6.2 mU/l，p<0.005，给药后水平降至7.0±3.5 mU/l，p<0.005。然而，在最后一剂奥曲肽后20小时重复进行葡萄糖钳夹时，钳夹葡萄糖需求量、前臂葡萄糖摄取或刺激的胰岛素分泌均未检测到变化。得出的结论是，降低胰岛素水平一周并不能逆转肝硬化的胰岛素抵抗。
