Freyse E J, Becher T, El-Hag O, Knospe S, Göke B, Fischer U
Gerhardt Katsch Institute of Diabetes Karlsburg of the Ernst Moritz Arndt University, Greifswald, Germany.
Diabetes. 1997 May;46(5):824-8. doi: 10.2337/diab.46.5.824.
To establish potential effects of glucagon-like peptide I (GLP-I) on blood glucose control in insulin-deficient states, GLP-I [GLP-I(7-36) amide; 10 pmol x kg(-1) x min(-1)] was infused intravenously in six fasting, canine C-peptide-negative, chronically diabetic dogs for 8 h. Blood samples were saved for the analysis of hormones, metabolites, and turnover rates of glucose (6-(3)H-glucose), alanine (U-(14)C-alanine), and urea ((15)N(2)-urea) starting 22 h after the last subcutaneous dose of exogenous insulin. Circulating plasma GLP-I levels rose under infusion from 2.9 +/- 0.8 to 41.4 +/- 10.1 pmol/l. This was efficient to significantly reduce the preexisting diabetic hyperglucagonemia. Since in the utilized model functioning pancreatic beta-cells are lacking, GLP-I had no insulinogenic effect. Compared with control experiments in the same animals receiving saline infusion, glycemia dropped from 20.8 +/- 1.9 to 16.2 +/- 1.0 mmol/l (P < 0.05). This was in parallel to the infusion of GLP-I and was most likely caused by a decrease of elevated glucose production since overall glucose turnover decreased with no alteration in glucose metabolic clearance. Alanine turnover was significantly reduced, obviously reflecting a decline in alanine production in relation to changed muscle glucose uptake under conditions of lower glycemia and overall glucose turnover. There was, however, neither an effect of GLP-I on alanine conversion into circulating glucose nor an effect on urea production rate, indicating unchanged gluconeogenesis from amino acid precursors. We conclude that the blood glucose-lowering effect of GLP-I in an animal model of insulinopenia was shown to be due to a reduction in hepatic glucose output, possibly secondary to reduction in glucagon concentrations leading to decreased glycogenolysis. Whether GLP-I might be therapeutically useful in clinical insulin-deficient diabetes needs to be verified.
为了确定胰高血糖素样肽I(GLP-I)在胰岛素缺乏状态下对血糖控制的潜在影响,对6只禁食的、犬C肽阴性的慢性糖尿病犬静脉输注GLP-I[GLP-I(7-36)酰胺;10 pmol·kg⁻¹·min⁻¹],持续8小时。在最后一次皮下注射外源性胰岛素22小时后,采集血样用于分析激素、代谢物以及葡萄糖(6-(³)H-葡萄糖)、丙氨酸(U-(¹⁴)C-丙氨酸)和尿素((¹⁵)N₂-尿素)的周转率。输注期间,循环血浆GLP-I水平从2.9±0.8 pmol/L升至41.4±10.1 pmol/L。这有效地显著降低了原有的糖尿病性高胰高血糖素血症。由于在所用模型中缺乏有功能的胰腺β细胞,GLP-I没有促胰岛素分泌作用。与接受生理盐水输注的同组动物对照实验相比,血糖从20.8±1.9 mmol/L降至16.2±1.0 mmol/L(P<0.05)。这与GLP-I的输注同时发生,很可能是由于葡萄糖生成增加的情况减少,因为总体葡萄糖周转率下降,而葡萄糖代谢清除率没有改变。丙氨酸周转率显著降低,明显反映出在血糖较低和总体葡萄糖周转率改变的情况下,与肌肉葡萄糖摄取变化相关的丙氨酸生成减少。然而,GLP-I对丙氨酸转化为循环葡萄糖没有影响,对尿素生成率也没有影响,表明从氨基酸前体的糖异生没有改变。我们得出结论,在胰岛素缺乏动物模型中,GLP-I的降血糖作用被证明是由于肝葡萄糖输出减少,可能继发于胰高血糖素浓度降低导致糖原分解减少。GLP-I在临床胰岛素缺乏性糖尿病中是否具有治疗作用需要进一步验证。