Early Phase of Insulin Release
Early Phase of Insulin Release
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胰岛素释放的早期阶段
作者：
R. Simpson;A. Benedetti;G. Grodsky;J. Karam;P. Forsham
在不同的临床条件下，系统地研究了静脉注射葡萄糖、胰高血糖素和葡萄糖加胰高血糖素后前5分钟胰岛素释放的早期阶段。在正常受试者中，葡萄糖、胰高血糖素和葡萄糖加胰高血糖素输注后胰岛素立即释放。后一种组合产生的胰岛素水平最高。在一组具有糖尿病遗传的非肥胖受试者中，一些人胰岛素的早期释放受损，但他们的平均反应与正常组没有显着差异。对非肥胖的潜在糖尿病患者（父母都患有糖尿病的后代）的调查显示，在胰岛素释放的早期阶段，即使静脉内葡萄糖耐量正常，他们的胰岛素水平也会下降。十分之四的受试者反应正常。非肥胖、非胰岛素依赖的糖尿病患者对输注葡萄糖没有胰岛素反应，但当向葡萄糖中添加胰高血糖素时，观察到胰岛素显著快速释放。然而，在葡萄糖加胰高血糖素治疗后，这种反应的幅度大约是正常受试者的一半。最后，在肥胖的非糖尿病受试者中研究了胰岛素释放的早期阶段，他们对每种刺激都表现出夸大的胰岛素释放。再一次，葡萄糖加胰高血糖素是最有效的胰岛素释放刺激物。据推测，胰岛素释放早期阶段的损害可能是糖尿病患者胰岛素分泌的第一个可检测到的异常，而胰高血糖素具有使其恢复正常的能力。
The early phase of insulin release in the first five minutes after intravenous administration of glucose, glucagon, and glucose-plus-glucagon was investigated systematically in various clinical conditions. In normal subjects there is an immediate release of insulin after glucose, glucagon, and glucose-plus-glucagon infusions. The latter combination produced the highest insulin levels. Of a group of nonobese subjects with diabetic heritage, some had impaired early release of insulin, but0 their mean response did not differ significantly from the normal group. Investigation of nonobese potential diabetics (offspring of two diabetic parents) revealed that as a group average they had decreased insulin levels during the early phase of insulin release, even though intravenous glucose tolerance was normal. Four of ten subjects had a normal response. Nonobese, noninsulin-dependent diabetics had no insulin response to infused glucose, but when glucagon was added to glucose a significant and rapid insulin discharge was observed. However, the magnitude of this response was about half that seen in normal subjects after glucose-plusglucagon. Finally, the early phase of insulin release was studied in obese nondiabetic subjects who demonstrated an exaggerated insulin release to each stimulus. Again, glucose-plusglucagon was the most potent stimulator of insulin release. It is postulated that impairment in the early phase of insulin release may be the first detectable abnormality of insulin secretion in diabetes mellitus and that glucagon has the capability of restoring this toward normal.