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生长抑素在健康受试者及成年起病型糖尿病患者中的致糖尿病作用。

The diabetogenic action of somatostatin in healthy subjects and in maturity onset diabetics.

作者信息

Waldhäusl W, Bratusch-Marrain P, Dudczak R, Deutsch E

出版信息

J Clin Endocrinol Metab. 1977 May;44(5):876-83. doi: 10.1210/jcem-44-5-876.

Abstract

To determine whether cyclic somatostatin (GH-RIH) interferes with glucose utilization and gluconeogenesis we studied levels of blood glucose (BG), immunoreactive insulin (IRI), immunoreactive glucagon (IRG) and of human growth hormone (GH) after iv glucose (330 mg/kg) and iv arginine (0.5 g/kg) in healthy subjects (n=8) and in maturity onset diabetics (n=8; fasting BG less than 200 mg/dl) both in the presence and in the absence of GH-RIH (500 microng/h iv). GH-RIH caused a reduction of glucose utilization in healthy subjects as shown by the decrease of the k-value from 2.08+/-0.22 (SE) % per min to 0.61+/-0.06 (SE) % per min (P less than 0.0005). No significant change of the glucose disappearance rate was observed in maturity onset diabetics by GH-RIH (kI=0.55+/-0.14 (SE) % per min; kII=0.42+/-0.03 (SE) % per min). The response of insulin to glucose was abolished by GH-RIH. The glucose induced suppression of IRG was in part significantly enhanced by GH-RIH in maturity onset diabetics (P less than 0.01). BG rises seen after iv arginine were increased by the administration of GH-RIH both in healthy subjects (P less than 0.001) and in maturity onset diabetics (P less than 0.05). Somatostatin abolished IRI and GH responses to arginine in both groups studied (P less than 0.001). IRG increases after arginine administration were diminished by GH-RIH in both groups (P less than 0.01). Our data demonstrate that GH-RIH impairs the iv carbohydrate tolerance in healthy subjects and facilities an increased hepatic glucose output upon administration of arginine both in controls and in maturity onset diabetics. We attribute the diabetogenic effect of somatostatin to suppression of IRI release rather than to changes in the IRG/IRI ratio in favor of IRG.

摘要

为了确定环孢素生长抑素(生长激素释放抑制激素,GH-RIH)是否干扰葡萄糖利用和糖异生,我们研究了健康受试者(n = 8)和成年型糖尿病患者(n = 8;空腹血糖低于200mg/dl)在静脉注射葡萄糖(330mg/kg)和静脉注射精氨酸(0.5g/kg)后,在有和没有GH-RIH(500μg/h静脉注射)的情况下,血糖(BG)、免疫反应性胰岛素(IRI)、免疫反应性胰高血糖素(IRG)和人生长激素(GH)的水平。GH-RIH导致健康受试者的葡萄糖利用率降低,k值从每分钟2.08±0.22(SE)%降至每分钟0.61±0.06(SE)%(P<0.0005)。GH-RIH在成年型糖尿病患者中未观察到葡萄糖消失率的显著变化(kI = 0.55±0.14(SE)%每分钟;kII = 0.42±0.03(SE)%每分钟)。GH-RIH消除了胰岛素对葡萄糖的反应。在成年型糖尿病患者中,GH-RIH部分显著增强了葡萄糖诱导的IRG抑制(P<0.01)。静脉注射精氨酸后出现的BG升高在健康受试者(P<0.001)和成年型糖尿病患者(P<0.05)中均因给予GH-RIH而增加。生长抑素在两组研究对象中均消除了IRI和GH对精氨酸的反应(P<0.001)。两组中,GH-RIH均降低了精氨酸给药后IRG的增加(P<0.01)。我们的数据表明,GH-RIH损害了健康受试者的静脉碳水化合物耐量,并促进了对照组和成年型糖尿病患者在给予精氨酸后肝脏葡萄糖输出增加。我们将生长抑素的致糖尿病作用归因于对IRI释放的抑制,而不是有利于IRG的IRG/IRI比值变化。

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