Glucose counterregulatory hormones in the 72-hour fast.
Glucose counterregulatory hormones in the 72-hour fast.
复制标题
72小时禁食期间的血糖反调节激素。
作者：
A. Vella;P. O'brien
目的
尝试建立低血糖期间胰高血糖素浓度的参考范围。
方法
我们测量了65名胰岛素瘤患者和29名正常对照受试者的胰高血糖素、皮质醇和生长激素反应，这些受试者进行了72小时的禁食。为了比较，我们还评估了8例非胰岛素瘤胰源性低血糖综合征患者的这些反应。
结果
在禁食结束时，（19.0 mg/dL [范围，3.7至44.0]对比11.0 mg/dL [范围，5.0至28.0]; P<0.001）和生长激素水平（分别为3.5 ng/mL [范围，0.1 - 46.0]和1.2 ng/mL [范围，0.1 - 34.0]; P = 0.021）较高，而血浆胰高血糖素（分别为54.5 pg/mL [范围：11.0 - 170.0] vs 75.0 pg/mL [范围：17.0 - 940.0]; P = 0.012），胰岛素瘤患者（血清葡萄糖水平，39 mg/dL [范围，14 - 58]）低于对照受试者（血清葡萄糖水平，63 mg/dL [范围，47 - 89]）。与此相反，8例非胰岛素瘤胰源性低血糖综合征患者，一种餐后高胰岛素血症性低血糖症，72小时空腹时正常，（血清葡萄糖水平，71.5 mg/dL [范围，48 - 82]），胰高血糖素浓度（81.0 pg/mL [范围，47.0 - 150.0]）、皮质醇（10.5 mg/dL [范围，2.7 - 17.0]）和生长激素（1.5 ng/mL [范围，0.8 - 6.9]）与对照受试者相似。在多变量分析中，空腹持续时间、基线胰高血糖素浓度和男性性别（但不包括年龄、体重指数或葡萄糖和胰岛素浓度）与空腹结束时胰高血糖素浓度相关。
结论
低血糖障碍中胰高血糖素分泌缺陷适用于低血糖刺激，但不适用于食物剥夺。根据观察到的最小胰高血糖素反应，低血糖期间胰高血糖素缺乏的保守估计值可能为10 pg/mL。
OBJECTIVE
To attempt to establish a reference range of glucagon concentrations during hypoglycemia.
METHODS
We measured glucagon, cortisol, and growth hormone responses in 65 patients with insulinoma and 29 normal control subjects who underwent a 72-hour fast. For comparison, we also assessed these responses in eight patients with noninsulinoma pancreatogenous hypoglycemia syndrome.
RESULTS
At the end of the fasts, median serum cortisol (19.0 mg/dL [range, 3.7 to 44.0] versus 11.0 mg/dL [range, 5.0 to 28.0], respectively; P<0.001) and growth hormone levels (3.5 ng/mL [range, 0.1 to 46.0] versus 1.2 ng/mL [range, 0.1 to 34.0], respectively; P = 0.021) were higher, whereas plasma glucagon (54.5 pg/mL [range, 11.0 to 170.0] versus 75.0 pg/mL [range, 17.0 to 940.0], respectively; P = 0.012) was lower in patients with insulinoma (serum glucose level, 39 mg/dL [range, 14 to 58]) than in control subjects (serum glucose level, 63 mg/dL [range, 47 to 89]). In contrast, the 8 patients with noninsulinoma pancreatogenous hypoglycemia syndrome, a disorder of postprandial hyperinsulinemic hypoglycemia with normal findings on a 72-hour fast (serum glucose level, 71.5 mg/dL [range, 48 to 82]), had concentrations of glucagon (81.0 pg/mL [range, 47.0 to 150.0]), cortisol (10.5 mg/dL [range, 2.7 to 17.0]), and growth hormone (1.5 ng/mL [range, 0.8 to 6.9]) similar to those in the control subjects. On multivariate analysis, the duration of the fast, baseline glucagon concentration, and male gender (but not age, body mass index, or concentrations of glucose and insulin) were correlated with end-of-fast glucagon concentration.
CONCLUSION
Defective glucagon secretion in hypoglycemic disorders applies to the stimulus of hypoglycemia but not to food deprivation. A conservative estimate for glucagon deficiency based on the minimal observed glucagon response could be a level of 10 pg/mL during hypoglycemia.
影响因子：
158.5
作者：
MITRAKOU, A;FANELLI, C;BOLLI, G
通讯作者：
BOLLI, G
生理性高胰岛素血症对人类低血糖期间反调节激素反应的影响。
DOI：
10.1210/jcem.75.5.1430091
发表时间：
1992
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
--
作者：
Mellman,MJ;Davis,MR;Shamoon,H
通讯作者：
Shamoon,H
胰岛素瘤患者低血糖期间反调节激素反应不足。
DOI：
10.1210/jcem-72-4-788
发表时间：
1991
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
--
作者：
Davis,MR;Shamoon,H
通讯作者：
Shamoon,H