Grill V, Alvarsson M
Department of Molecular Medicine, Karolinska Hospital, Stockholm, Sweden.
Diabet Med. 1996 Sep;13(9 Suppl 6):S37-9.
Healthy subjects with previously observed low insulin responses to i.v. glucose have been further characterized. A low insulin response was relatively stable over decades. Adaptability to increased demands for insulin secretion was poor. Hence, dexamethasone treatment for 60 h induced insulin resistance but did not enhance insulin responses to glucose or to arginine. Birth weight was not associated with low insulin responses. Data are compatible with major influences of inherent factors on insulin secretion. Low insulin responses in healthy subjects were compared with responses in glucokinase-deficient subjects. Second phase of glucose-induced insulin secretion and glucose-dependent potentiation of arginine-induced secretion were decreased in both groups. However, the first phase response to glucose was higher in glucokinase-deficient subjects. Hence, decreased first phase insulin secretion is not specifically linked to deficiencies in beta-cell metabolism.
对静脉注射葡萄糖先前观察到胰岛素反应较低的健康受试者已得到进一步特征描述。低胰岛素反应在几十年间相对稳定。对胰岛素分泌增加需求的适应性较差。因此，地塞米松治疗60小时可诱导胰岛素抵抗，但不会增强对葡萄糖或精氨酸的胰岛素反应。出生体重与低胰岛素反应无关。数据与内在因素对胰岛素分泌的主要影响相符。将健康受试者的低胰岛素反应与葡萄糖激酶缺乏受试者的反应进行了比较。两组中葡萄糖诱导的胰岛素分泌的第二阶段以及精氨酸诱导分泌的葡萄糖依赖性增强均降低。然而，葡萄糖激酶缺乏受试者对葡萄糖的第一阶段反应更高。因此，第一阶段胰岛素分泌减少并非与β细胞代谢缺陷有特异性关联。
