Hormonal Profile after Insulin-Induced Hypoglycemia in Chronic Calcific Pancreatitis: Pancreatic, Pituitary and Adrenal Responses
Hormonal Profile after Insulin-Induced Hypoglycemia in Chronic Calcific Pancreatitis: Pancreatic, Pituitary and Adrenal Responses
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慢性钙化性胰腺炎胰岛素诱发低血糖后的激素特征：胰腺、垂体和肾上腺反应
DOI：
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发表时间：
1984
期刊：
影响因子：
--
通讯作者：
Seftel Hc
中科院分区：
文献类型：
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作者：
B. Joffe;I. Spitz;Hirsch Hj;R. Shires;I. Segal;Seftel Hc
本研究明确了与酒精滥用相关的慢性钙化性胰腺炎（CCP）患者胰岛素诱导低血糖后胰腺、垂体和肾上腺的反应模式，并评估了其中一些激素在血糖反调节中的作用。我们研究了6名最近诊断为CCP的黑人男性，均显示胰腺钙化和正常葡萄糖耐量的影像学证据，以及7名匹配的非肥胖男性对照。在标准的静脉胰岛素耐量试验诱导明显的低血糖后，CCP患者的平均血浆胰高血糖素和胰多肽反应明显低于对照组。慢性胰腺炎的平均基础血浆生长抑素水平趋于较高，并在整个试验过程中保持不变，没有持续改变；在对照组中，生长抑素在30分钟达到峰值。胰外激素变化方面，血浆生长激素、催乳素和总儿茶酚胺在CCP中反应正常，但血浆皮质醇在注射胰岛素后60和120分钟明显高于对照组。这与儿茶酚胺的快速输出相结合，可能阻止了由于低胰高血糖素血症而预期的对胰岛素的高度敏感性。我们得出结论，CCP患者在胰岛素低血糖后胰腺激素释放受损，但生长抑素除外；血浆皮质醇也会过度升高，这可能与过去长期滥用酒精有关。
The present investigation defined the pattern of pancreatic, pituitary and adrenal responses after insulin-induced hypoglycemia in chronic calcific pancreatitis (CCP) related to alcohol abuse, and assessed the role of some of these hormones in the counterregulation of blood glucose. We studied 6 Black men with recently diagnosed CCP, all showing radiological evidence of pancreatic calcification and normal glucose tolerance, as well as 7 matched nonobese male controls. After a standard iv insulin tolerance test inducing marked hypoglycemia, patients with CCP showed significantly impaired mean plasma pancreatic glucagon and pancreatic polypeptide responses compared to the controls. Mean basal plasma somatostatin levels tended to be higher in chronic pancreatitis and remained so throughout the test without altering consistently; in the controls somatostatin peaked significantly at 30 min. Concerning extrapancreatic hormonal changes, plasma growth hormone, prolactin and total catecholamines responded normally in CCP, but plasma cortisol rose to significantly higher levels than controls at 60 and 120 min after the injection of insulin. This, coupled with the brisk output of catecholamines, may have prevented the heightened sensitivity to insulin anticipated because of their hypoglucagonemia. We conclude that patients with CCP show impaired pancreatic hormone release after insulin hypoglycemia with the exception of somatostatin; there is also an excessive rise in plasma cortisol, possibly related to the long standing abuse of alcohol in the past.
胰岛素引起的严重低血糖与反调节激素释放不足有关。
DOI：
10.1056/nejm198111123052007
发表时间：
1981
期刊：
The New England journal of medicine
影响因子：
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作者：
Boden,G;ReichardJr,GA;Hoeldtke,RD;Rezvani,I;Owen,OE
通讯作者：
Owen,OE