DEXAMETHASONE-INDUCED INSULIN RESISTANCE ENHANCES B-CELL RESPONSIVENESS TO GLUCOSE LEVEL IN NORMAL MEN
DEXAMETHASONE-INDUCED INSULIN RESISTANCE ENHANCES B-CELL RESPONSIVENESS TO GLUCOSE LEVEL IN NORMAL MEN
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DOI：
10.1152/ajpendo.1984.247.5.e592
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发表时间：
1984-01-01
影响因子：
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通讯作者：
PORTE, D
中科院分区：
文献类型：
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作者：
BEARD, JC;HALTER, JB;PORTE, D
为了确定胰岛素抵抗期间胰岛适应是否涉及对血浆葡萄糖水平的反应性增加，对9名正常男性进行了胰岛素抵抗诱导，给予地塞米松（3 mg，每天2次，连续2天）。在正常和右旋肾上腺素条件下，测定3种不同血糖水平下血浆胰岛素和急性胰岛素反应（AIR）。在Dex期间，基础葡萄糖高于对照水平（104 +-）。2 vs. 94。3毫克/分升)和胰岛素(21。3 . vs. 13 .+-2 .mu。U/ml， P均< 0.03)。当葡萄糖水平通过葡萄糖钳的匹配量逐步升高时，在两种情况下，AIR与异丙肾上腺素的比值随葡萄糖水平的线性函数升高，但在DEX期间上升得更陡。葡萄糖（. delta . air /. delta .glucose）在Dex: 1.3 +-时的增强作用更大。0.2 vs. 0.8。0.2 （p < 0.01）。同样，在DEX期间，葡萄糖水平的相应增加会产生更大的刺激前胰岛素水平的增加（P < 0.03）。显然，48小时的Dex增加了葡萄糖增强效应的“增益”。由于糖皮质激素对B细胞功能的直接作用已被报道为抑制作用，因此所观察到的刺激很可能是Dex引起的胰岛素抵抗的结果。
To determine whether islet adaptation during insulin resistance involves incresaed responsiveness to the level of plasma glucose, insulin resistance was induced in 9 normal men by giving dexamethasone (Dex) (3 mg twice daily for 2 days). Plasma insulin and acute insulin responses (AIR) to isoproterenol were measured at 3 different glucose levels under control and Dex conditions. During Dex there were elevations above control levels of basal glucose (104 .+-. 2 vs. 94 .+-. 3 mg/dl) and insulin (21 .+-. 3 vs. 13 .+-. 2 .mu.U/ml, both P < 0.03). When glucose levels were raised stepwise by matching amounts using glucose clamps, AIR to isoproterenol rose as a linear function of glucose level under both conditions but rose more steeply during DEX. The potentiating effect of glucose (.DELTA.AIR/.DELTA.glucose) was greater during Dex: 1.3 .+-. 0.2 vs. 0.8 .+-. 0.2 (P < 0.01). Similarly, matched increments in glucose level produced greater increments in prestimulus insulin level during DEX (P < 0.03). Apparently 48 h of Dex raises the "gain" of the potentiating effect of glucose. Because the direct effect of glucocorticoids on B cell function has been reported inhibitory, the observed stimulation is likely to be a result of the insulin resistance caused by Dex.