SECRETION OF GLUCAGON-LIKE PEPTIDE-1 AND REACTIVE HYPOGLYCEMIA AFTER PARTIAL GASTRECTOMY
SECRETION OF GLUCAGON-LIKE PEPTIDE-1 AND REACTIVE HYPOGLYCEMIA AFTER PARTIAL GASTRECTOMY
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DOI：
10.1159/000201151
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发表时间：
1994-07-01
期刊：
影响因子：
3.2
通讯作者：
HOLST, JJ
中科院分区：
文献类型：
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作者：
ANDREASEN, JJ;ORSKOV, C;HOLST, JJ
胰高血糖素样肽-1是来自小肠远端的肽激素，其刺激胰岛素分泌并抑制胰高血糖素分泌，从而降低血糖。因此，这种激素可能参与了餐后反应性低血糖的发病机制。我们对8例胃部分切除术后早期倾倒症状的患者进行了口服100 g葡萄糖负荷，并在摄入后3.5 h测量了血糖和血浆胰岛素、C肽、胰高血糖素、肠胰高血糖素和GLP-1浓度。10个匹配的对照组进行了类似的处理。患者在最初60分钟的血糖浓度较高，但在剩余的测试期内血糖浓度较低，在葡萄糖给药后146 +/- 17分钟达到最低值2.76 +/- 0.19 mmol/l（对照组：210 +/- 9分钟为3.36 +/- 0.21 mmol/l）。GLP-1和肠胰高血糖素反应在患者中显著升高，与对照组相比，胰岛素和C肽水平在最初60分钟内较高。胰高血糖素浓度在患者中升高，在对照组中降低。当发生低血糖时，GLP-1水平仅中度升高，胰岛素和C肽水平较低，胰高血糖素水平高于对照组。因此，GLP-1释放以外的机制似乎是观察到的葡萄糖和糖调节激素浓度变化的原因。
Glucagon-like peptide-1 is a peptide hormone from the distal small intestine which stimulates insulin secretion and inhibits glucagon secretion and thereby lowers blood glucose. This hormone, therefore, could be involved in the pathogenesis of postprandial reactive hypoglycemia. We subjected 8 patients showing symptoms of early dumping after partial gastrectomy to an oral 100 g glucose load and measured blood glucose and plasma insulin, C-peptide, glucagon, enteroglucagon and GLP-1 concentrations for 3.5 h after ingestion. Ten matched controls were treated similarly. The patients had higher blood glucose concentrations for the initial 60 min, but lower values for the remaining test period with a nadir of 2.76 +/- 0.19 mmol/l at 146 +/- 17 min after glucose (controls: 3.36 +/- 0.21 mmol/l at 210 +/- 9 min). GLP-1 and enteroglucagon responses were grossly elevated in patients compared to controls and insulin and C-peptide levels were higher during the initial 60 min. Glucagon concentrations increased in patients and decreased in controls. When hypoglycemia occurred, GLP-1 levels were only moderately elevated and insulin and C-peptide levels were lower and glucagon levels higher in patients than in controls. Thus, mechanisms other than release of GLP-1 seem to be responsible for the observed changes in the concentrations of glucose and glucoregulatory hormones.