EFFECTS OF HEMIPANCREATECTOMY ON INSULIN-SECRETION AND GLUCOSE-TOLERANCE IN HEALTHY HUMANS
EFFECTS OF HEMIPANCREATECTOMY ON INSULIN-SECRETION AND GLUCOSE-TOLERANCE IN HEALTHY HUMANS
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DOI：
10.1056/nejm199003293221305
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发表时间：
1990-03-29
影响因子：
158.5
通讯作者：
ROBERTSON, RP
中科院分区：
文献类型：
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作者：
KENDALL, DM;SUTHERLAND, DER;ROBERTSON, RP
通过半胰腺切除术从健康的活体亲属供体获得的胰腺组织已被移植到患有I型糖尿病的受体中。为了确定这一程序的捐助者的代谢后果，我们进行了口服葡萄糖耐量试验和24小时监测血糖水平和尿C肽排泄作为衡量胰岛素分泌的28名捐助者，无论是前和一年后半胰腺切除术。术后一年平均空腹血糖水平显著升高（平均值± 0.01）。标准差，5.4 ±。0.9 vs. 4.9 .+-。0.5 003），给予葡萄糖后两小时的血清葡萄糖值也是如此（8.7 ± 0.001 mmol/L; P < 0.003）。2.9 vs. 6.5 .+-。1.0 mmol/L; P < 0.001）。半胰切除术后一年，空腹血清胰岛素水平显着降低（33.0 . ±. 21.6与38.4 .+-相比。21.6 pmol/L; P < 0.05），口服葡萄糖耐量试验期间胰岛素曲线下面积（52，554. ±. 22,320对76,320 +-。33、354 pmol/L/min; P < 0.04）。在接受这些研究的17名供体中，平均24小时血清葡萄糖曲线值在1年时较高，24小时尿C肽排泄较低。28例供者中有7例在术后1年出现糖耐量异常，但这7例供者的胰岛素分泌与21例糖耐量正常供者的胰岛素分泌无明显区别。所有28名献血者的空腹血糖浓度均低于7.9 mmol/L，他们的平均24小时血糖水平保持在正常范围内。我们的结论是，在健康的捐助者半胰腺切除术的结果恶化的胰岛素分泌和葡萄糖耐量，一年后测量。需要进一步研究以确定临床糖尿病的发展是否是半胰切除术的固有风险。
Pancreatic tissue obtained by hemipancreatectomy from healthy living related donors has been transplanted into recipients with Type I diabetes mellitus. To determine the metabolic consequences of this procedure for the donors, we carried out oral glucose-tolerance testing and 24-hour monitoring of serum glucose levels and urinary C-peptide excretion as a measure of insulin secretion in 28 donors, both before and one year after hemipancreatectomy. The mean fasting serum glucose level was significantly higher one year after the procedure (mean .+-. SD, 5.4 .+-. 0.9 vs. 4.9 .+-. 0.5 mmol per liter; P < 0.003), as was the serum glucose value two hours after the administration of glucose (8.7 .+-. 2.9 vs. 6.5 .+-. 1.0 mmol per liter; P < 0.001). The fasting serum insulin level was significantly lower one year after hemipancreatectomy (33.0 .+-. 21.6 vs. 38.4 .+-. 21.6 pmol per liter; P < 0.05), as was the area under the insulin curves during the oral glucose-tolerance test (52,554 .+-. 22,320 vs. 76,320 .+-. 33, 354 pmol per liter per minute; P < 0.04). The mean 24-hour serum glucose-profile value was higher at one year, and the 24-hour urinary C-peptide excretion was lower in the 17 donors who underwent these studies. Seven of the 28 donors that abnormal glucose tolerance one year after hemipancreatectomy; however, insulin secretion in these 7 donors ws indistinguishable from that in the 21 donors who had normal glucose tolerance. All 28 donors had fasting serum glucose concentrations lower than 7.9 mmol per liter, and their mean 24-hour plasma glucose levels remained within the normal range. We conclude that in healthy donors hemipancreatecttomy results in a deterioration of insulin secretion and glucose tolerance, as measured one year later. Further study is required to ascertain whether the development of clinical diabetes mellitus is a risk inherent in hemipancreatectomy.