KINETICS OF CIRCULATING ENDOGENOUS INSULIN, C-PEPTIDE, AND PROINSULIN IN FASTING NONDIABETIC MAN
KINETICS OF CIRCULATING ENDOGENOUS INSULIN, C-PEPTIDE, AND PROINSULIN IN FASTING NONDIABETIC MAN
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DOI：
10.1016/0026-0495(87)90044-8
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发表时间：
1987-05-01
影响因子：
9.8
通讯作者：
BULOW, JB
中科院分区：
文献类型：
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作者：
HENRIKSEN, JH;TRONIER, B;BULOW, JB
在不同血管床中测量胰岛素、C肽和胰岛素原的血浆浓度，以确定空腹条件下内源性肽的肾脏、肝脏和全身动力学。研究了19名非糖尿病受试者，其中2名正常，9名有轻微血管疾病，4名有肝硬化但无器质性肾病，4名有器质性肾病伴肾小球滤过率中度降低。在无器质性肾病的受试者中，胰岛素、C肽和胰岛素原的动静脉提取率平均值分别为0.27、0.20和0.21（n = 14）。这些值在患有器质性疾病的肾脏中显著降低。胰岛素、C肽和胰岛素原的肾血浆清除率平均值分别为113、87和90 mL/min（n = 6）。尿清除率显著较低（分别为0.8、13、3.5 mL/min），表明这些肽在正常肾脏中也发生显著降解。在无肝脏疾病的受试者中，假设肝脏不清除C肽，估计的胰岛素肝脏提取率平均为0.48。内源性释放的胰岛素从肾脏、肝脏和其他地方的血浆中以大约10%：65%：25%的比例去除，而C肽在肾脏中去除一半，在其他地方去除另一半。胰岛素和C肽的总体代谢清除率估计分别为15和4.5 mL/min/kg。结果表明，肾脏对胰岛素、C肽、胰岛素原的清除有很大贡献，主要通过降解，较少通过尿排泄。
Plasma concentrations of insulin, C-peptide, and proinsulin were measured in different vascular beds in order to determine renal, hepatic, and systemic kinetics of the endogenous peptides in the fasting condition. Nineteen nondiabetic subjects were studied, two were normal, nine had minor vascular disorders, four had cirrhosis without organic kidney disease, and four had organic kidney disease with moderately decreased glomerular filtration rate. In subjects without organic kidney disease the arteriorenal venous extraction ratios of insulin, C-peptide, and proinsulin were mean 0.27, 0.20, and 0.21, respectively (n = 14). These values were significantly reduced in kidneys with organic disease. Renal plasma clearance values of insulin, C-peptide, and proinsulin were mean 113, 87, and 90 mL/min, respectively (n = 6). Urinary clearances were substantially lower (0.8, 13, 3.5 mL/min, respectively), indicating that a significant degradation of these peptides also takes place in the normal kidney. In subjects without liver disease the estimated hepatic extraction ratio of insulin was mean 0.48, under the assumption that no C-peptide is removed by the liver. Endogenously released insulin was removed from plasma in kidney, liver, and elsewhere in the approximate proportion 10%:65%:25%, whereas, C-peptide was removed by one half in kidney and the other half elsewhere. The overall metabolic clearance rates of insulin and C-peptide were estimated to be 15 and 4.5 mL/min/kg, respectively. The results indicate that the kidney contributes substantially to removal of insulin, C-peptide, an proinsulin, mainly by degradation, less by urinary excretion.