[胰岛素瘤患者葡萄糖的内源性产生和外周利用]。

Diabete & metabolisme Pub Date : 1995-12-01
H Gin, V Rigalleau, G Deleris, J Aubertin
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引用次数: 0

摘要

我们测量了5例胰岛素瘤患者在手术切除肿瘤前和手术切除后3 ~ 6个月的内源性葡萄糖生成(EGP)、葡萄糖清除率和胰岛素敏感性。内源性葡萄糖生成和葡萄糖清除率通过输注[6,6 D2]葡萄糖来评估,胰岛素敏感性通过高胰岛素血症血糖钳来测定。这些病人作为他们自己的对照。治疗前吸收后血糖水平较低(0.51 +/- 0.01 g/l), EGP为1.86 +/- 0.10 mg kg-1 min-1(正常值2.2 ~ 2.6 mg kg-1 min-1),而胰岛素水平较高(16.4 +/- 1.6 mU/l)。手术切除胰岛素瘤后,血糖升高至0.94 +/- 0.02 g/l, EGP升高至2.33 +/- 0.04 mg kg-1 min-1,而胰岛素水平下降至6.4 +/- 0.5 mU/l。术前空腹糖代谢清除率为3.68 +2- 0.21 mg kg-1 min-1,术后空腹糖代谢清除率为2.46 +/- 0.09 (n = 2.44 ~ 3.46 ml kg-1 min-1)。钳形剂量-反应曲线左移,术后胰岛素敏感性改善。这些数据表明,慢性高胰岛素血症与内源性葡萄糖产生的抑制、基础葡萄糖清除率的升高和钳夹期间胰岛素不敏感状态有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Endogenous production and peripheral utilization of glucose in patients with insulinoma].

Endogenous glucose production (EGP), glucose clearance and insulin sensitivity were measured in 5 subjects with insulinoma before and 3 to 6 months after surgical resection of the tumour. Endogenous glucose production and glucose clearance were evaluated by infusion of [6,6 D2] glucose, and insulin sensitivity was determined by a euglycaemic hyperinsulinaemic glucose clamp. The patients served as their own controls. The postabsorption blood glucose level was low before treatment (0.51 +/- 0.01 g/l) and EGP was 1.86 +/- 0.10 mg kg-1 min-1 (normal value: 2.2 to 2.6 mg kg-1 min-1), whereas the insulin level was relatively high (16.4 +/- 1.6 mU/l). After surgical resection of the insulinoma, the blood glucose level rose to 0.94 +/- 0.02 g/l and EGP to 2.33 +/- 0.04 mg kg-1 min-1, whereas the insulin level fell to 6.4 +/- 0.5 mU/l. Glucose metabolic clearance in the fasting state was 3.68 +2- 0.21 mg kg-1 min-1 before and 2.46 +/- 0.09 (n = 2.44 to 3.46 ml kg-1 min-1) after surgery. Clamp dose-response curves were shifted to the left and insulin sensitivity was improved after surgery. These data suggest that chronic hyperinsulinaemia is associated with inhibition of endogenous glucose production, a rise in basal glucose clearance and a state of insulin insensitivity during the clamp.

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