Estrogen blunts neuroendocrine and metabolic responses to hypoglycemia
Estrogen blunts neuroendocrine and metabolic responses to hypoglycemia
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DOI：
10.2337/diabetes.52.7.1749
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发表时间：
2003-07-01
期刊：
影响因子：
7.7
通讯作者：
Davis, SN
中科院分区：
文献类型：
--
作者：
Sandoval, DA;Ertl, AC;Davis, SN
本研究验证了雌激素是低血糖神经内分泌和代谢反应中性二态性机制的假设。在单步2小时高胰岛素-低血糖钳夹试验中，将接受（E2; n = 8）或未接受（NO E2; n = 9）雌激素替代的绝经后妇女与年龄和BMI匹配的男性受试者（n = 8）进行比较。在葡萄糖钳夹期间，所有组的血浆胰岛素（599 +/- 28 pmol/l）和葡萄糖（2.9 +/- 0.03 mmol/l）水平相似。在低血糖反应中，肾上腺素（2.8 +/- 0.6 vs. 5.8 +/- 0.8和4.4 +/- 0.5 nmol/l）、胰高血糖素（57 +/- 8 vs. 77 +/- 8和126 +/- 18 ng/l）和内源性葡萄糖生成（2 +/- 2 vs. 10 +/- 2和6 +/- 3 mumol . kg（-1）。min（-1））显著低于NO组和男性组（P < 0.05）。这些降低的反调节反应导致显著更大的葡萄糖输注速率（16 +/- 2 vs. 6 +/- 2和6 +/- 3 mumol . kg（-1）。min（-1）; P < 0.01）。E2组和NO E2组的胰多肽含量分别为136 20和136 23 pmol/l，明显低于男性（194 16 pmol/l）。最后，甘油（36 +/- 3 vs. 47 +/- 5 mumol/l; P < 0.05），乳酸（1.4 +/- 0.1 vs. 1.8 +/- 0.2 mmol/l; P < 0.05），以及肌肉交感神经活动（19 +/- 4至27 +/- 4 vs. 27 +/- 5至42 +/- 6次/min; P < 0.05）E2受试者对低血糖的反应均显著低于无E2受试者。我们的结论是，雌激素似乎发挥了重要作用，目前在健康人的性二型性低血糖的反调节反应。
This study tested the hypothesis that estrogen is the mechanism responsible for the sexual dimorphism present in the neuroendocrine and metabolic responses to hypoglycemia. Postmenopausal women receiving (E2; n = 8) or not receiving (NO E2; n = 9) estrogen replacement were compared with age- and BMI-matched male subjects (n = 8) during a single-step 2-h hyperinsulinemic-hypoglycemic clamp. Plasma insulin (599 +/- 28 pmol/l) and glucose (2.9 +/- 0.03 mmol/l) levels were similar among all groups during the glucose clamp. In response to hypoglycemia, epinephrine (2.8 +/- 0.6 vs. 5.8 +/- 0.8 and 4.4 +/- 0.5 nmol/l), glucagon (57 +/- 8 vs. 77 +/- 8 and 126 +/- 18 ng/l), and endogenous glucose production (2 +/- 2 vs. 10 +/- 2 and 6 +/- 3 mumol . kg(-1) . min(-1)) were significantly lower in E2 vs. both NO E2 and male subjects (P < 0.05). These reduced counterregulatory responses resulted in significantly greater glucose infusion rates (16 +/- 2 vs. 6 +/- 2 and 6 +/- 3 mumol . kg(-1) . min(-1); P < 0.01) in E2 vs. both NO E2 and male subjects. Pancreatic polypeptide was significantly lower (P < 0.05) in both the E2 and NO E2 groups compared with the male subjects (136 20 and 136 23 vs. 194 16 pmol/l). Last, glycerol (36 +/- 3 vs. 47 +/- 5 mumol/l; P < 0.05), lactate (1.4 +/- 0.1 vs. 1.8 +/- 0.2 mmol/l; P < 0.05), and muscle sympathetic nerve activity (19 +/- 4 to 27 +/- 4 vs. 27 +/- 5 to 42 +/- 6 bursts/min; P < 0.05) responses to hypoglycemia were all significantly lower in E2 vs. NO E2 subjects. We conclude that estrogen appears to play a major role in the sexual dimorphism present in counterregulatory responses to hypoglycemia in healthy humans.