Aronoff S L, Bennett P H, Rushforth N B, Miller M, Unger R H
J Clin Endocrinol Metab. 1976 Aug;43(2):279-86. doi: 10.1210/jcem-43-2-279.
To determine whether abnormalities in glucagon secretion might precede the onset of hyperglycemia in diabetes mellitus, 32 prediabetic Pima (American) Indians, 27 normal Pima Indians and 34 normal Caucasians received an infusion of arginine monochloride (5 mg/kg/min for 40 minutes) with measurement of glucose, insulin, and glucagon. [Prediabetes is the period between conception and the development of diabetes. In most studies the term is used to characterize patients who on genetic grounds are believed to be at high risk of developing the disease, including the normoglycemic monozygotic co-twin of a diabetic or the normoglycemic offspring of two diabetic parents. The latter definition is used in the present study recognizing that in the final analysis the true prediabetic can be identified only in retrospect after the development of diabetes.] The three groups had similar mean fasting glucagon levels. During arginine infusion, the prediabetic Indians reached a mean maximum glucagon level of 315 +/- 14 pg/ml (mean +/- 1 SEM) compared with 294 +/- 20 pg/ml in the normal Indians and 292 +/- 25 pg/ml in the normal Caucasians. The calculated mean areas above baseline under the glucagon curves were 5704 +/- 324 pg-min/ml in the prediabetics, 5189 +/- 446 pg-min/ml in the normal Indians, and 4239 +/- 613 pg/min/ml in the normal Caucasians. The differences among the groups in these variables were not statistically significant. Thus, arginine induced hyperglucagonemia could not be identified as a characteristic of the prediabetic state in Pima Indians.
为了确定糖尿病患者高血糖发作之前胰高血糖素分泌异常是否会出现,32名糖尿病前期皮马(美国)印第安人、27名正常皮马印第安人和34名正常高加索人接受了一氯化精氨酸输注(5毫克/千克/分钟,持续40分钟),并测量了血糖、胰岛素和胰高血糖素。[糖尿病前期是指从受孕到糖尿病发病的时期。在大多数研究中,该术语用于描述那些基于遗传因素被认为有患该病高风险的患者,包括糖尿病患者的血糖正常的同卵双胞胎或父母双方均为糖尿病患者的血糖正常的后代。本研究采用后一种定义,因为认识到最终只有在糖尿病发病后回顾才能确定真正的糖尿病前期患者。]三组的空腹胰高血糖素平均水平相似。在精氨酸输注期间,糖尿病前期印第安人的胰高血糖素平均最高水平达到315±14皮克/毫升(平均值±1个标准误),正常印第安人为294±20皮克/毫升,正常高加索人为292±25皮克/毫升。计算得出的胰高血糖素曲线下高于基线的平均面积,糖尿病前期患者为5704±324皮克-分钟/毫升,正常印第安人为5189±446皮克-分钟/毫升,正常高加索人为4239±613皮克/分钟/毫升。这些变量在组间的差异无统计学意义。因此,精氨酸诱导的高胰高血糖素血症不能被确定为皮马印第安人糖尿病前期状态的特征。