Summary
In order to compare the insulinogenic effects of glucose, arginine and glucagon, plasma immunoreactive insulin levels following oral glucose loading (50 g), intravenous arginine infusion (30 g for 45 min) and intravenous glucagon injection (1 mg) were determined in patients with diabetes mellitus, various endocrine diseases and chronic hepatitis. In patients with Cushing’s syndrome, plasma insulin responses to all three stimuli were exaggerated, whereas they were low in patients with pheochromocytoma. In other diseases, certain disparities were observed in plasma insulin responses. In patients with mild diabetes mellitus, insulin secretion elicited by glucose seems to be selectively impaired, because arginine and glucagon caused a rise in plasma insulin not significantly different from that in normal subjects. In patients with hyperthyroidism, plasma insulin responses to arginine and glucagon were either absent or limited, although rather a exaggerated response was noted following oral glucose loading. On the contrary, exaggerated responses to arginine and glucagon, and limited response to glucose were observed in hypothyroidism. In patients with chronic hepatitis, the responses of plasma insulin to glucose and arginine were both exaggerated, whereas the response to glucagon was comparable to that in normal subjects. These disparate responses suggest that glucose, arginine and glucagon act on the B-cell via different mechanisms.
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References
Althausen J. L., Stockholm M.: Influence of the Thyroid Gland on Absorption in the Digestive Tracts — Amer. J. Physiol.123, 577, 1938.
Andreani D., Fallucca F., Tamburrano G., Iavicoli M., Menzinger G.: Insulin, Glucagon and Growth Hormone in Primary Adult Myxoedema — Diabetologia10, 7, 1974.
Andreani D., Menzinger G., Fallucca F., Aliberti G., Tamburrano G., Cassano C.: Insulin Levels in Thyrotoxicosis and Primary Myxoedema: Response to Intravenous Glucose and Glucagon — Diabetologia6, 1, 1970.
Cerasi E., Luft R., Efendić S.: Decreased Sensitivity of the Pancreatic Beta Cells to Glucose in Prediabetic and Diabetic Subjects: a Glucose Dose-Response Study — Diabetes21, 224, 1972.
Doar J. W. H., Stamp T. C. B., Wynn V., Audhya T. K.: Effect of Oral and Intravenous Glucose Loading in Thyrotoxicosis: Studies of Plasma Glucose, Free Fatty Acid Plasma Insulin and Blood Pyruvate Levels — Diabetes18, 633, 1969.
Elrick H. G., Hlad C. J., Arai Y.: Influence of Thyroid Function on Carbohydrate Metabolism and a New Method for Assessing Response to Insulin — J. clin. Endocr.21, 387, 1961.
Floyd J. C. Jr., Fajans S. S., Conn J. W., Knopf R. F., Rull J.: Stimulation of Insulin Secretion by Amino Acids — J. clin. Invest.45, 1487, 1966.
Hales C. N., Randle P. J.: Immunoassay of Insulin with Insulin-Antibody Precipitate — Biochem. J.88, 137, 1963.
Hayakawa H.: Dynamics of Insulin Secretion in Liver Disease — Jap. J. Gastroent.67, 457, 1970.
Hoffman W. S.: Rapid Photoelectric Method for Determination of Glucose in Blood and Urine — J. biol. Chem.120, 51, 1937.
Holdsworth C. D., Besser G. M.: Influence of Gastric Emptying-Rate and of Insulin Response on Oral Glucose Tolerance in Thyroid Disease — Lancet2, 700, 1968.
Ikeda M.: Plasma Insulin Levels in Endocrine Diseases: Plasma Insulin Levels in the Patients with Hyperthyroidism — Folia endocr. jap.47, 291, 1971.
Imura H., Kato Y., Ikeda M., Morimoto M., Yawata M.: Effect of Adrenergic-Blocking or -Stimulating Agent on Plasma Growth Hormone, Immunoreactive Insulin, and Blood Free Fatty Acid Levels in Man — J. clin. Invest.50, 1069, 1971.
Kasperska T., Ławecki J., Rogala H., Czyżyk A.: The Behaviour of Insulinaemia in Patients with Liver Cirrhosis after Intravenous Administration of Glucose, Tolbutamide and Glucagon — Diabetologia7, 391, 1971.
Megyesi C., Samols E., Marks V.: Glucose Tolerance and Diabetes in Chronic Liver Disease — Lancet2, 1051, 1967.
Ness J. C., Takahashi T., Lee Y.: Thyroid Hormone on Amino Acids and Protein Metabolism. I. Concentration and Composition of Free Amino Acids in Blood Plasma of the Rat — Endocrinology85, 1166, 1969.
Perley M., Kipnis D. M.: Effect of Glucocorticoids on Plasma Insulin — New Engl. J. Med.274, 1237, 1966.
Porte D. Jr.: A Receptor Mechanism for the Inhibition of Insulin Release by Epinephrine in Man — J. clin. Invest.46, 86, 1967.
Porte D. Jr., Graber A. L., Kuzuya T., Williams R. H.: The Effect of Epinephrine on Immunoreactive Insulin Levels in Man — J. clin. Invest.45, 228, 1966.
Raptis S., Rau R. M., Schröder D. E., Rothenbuchner G., Pfeiffer E. F.: Die Dynamik der Insulinsekretion bei der Hypothyreose vor und während der Substitutionstherapie — Klin. Wschr.48, 362, 1970.
Rehfeld J. F., Juhl E., Hilden M.: Carbohydrate Metabolism in Alcohol-Induced Fatty Liver — Evidence for an Abnormal Insulin Response to Glucagon in Alcoholic Liver Disease — Gastroenterology64, 445, 1973.
Robertson R. P., Porte D. Jr.: The Glucose Receptor: a Defective Mechanism in Diabetes Mellitus Distinct from the Beta Adrenergic Receptor — J. clin. Invest.52, 870, 1973.
Samols E., Marri G., Marks V.: Promotion of Insulin Secretion by Glucagon — Lancet2, 415, 1965.
Seino Y.: Insulin Secretion in Patients with Diabetes Mellitus: Enhancement of Insulin Secretion in Adult Onset Diabetes by Several Drugs and Amino Acids — J. jap. Diabetes Soc.17, 221, 1974.
Seino Y., Goto Y., Taminato T., Ikeda M., Imura H.: Plasma Insulin and Glucagon Responses to Arginine in Patients with Thyroid Dysfunction — J. clin. Endocr.38, 1136, 1974.
Spergel G., Bleicher S. T., Ertel N. H.: Carbohydrate and Fat Metabolism in Patients with Pheochromocytoma — New Engl. J. Med.278, 803, 1968.
Trisotto A., Federspil G., Scandellari C., Frezzato S., Lazzarin M., Muggeo M., Tiengo A.: Tolleranza orale ai carboidrati e risposta insulinica nella tireotossicosi e nell’ipotiroidismo — Acta diabet. lat.6, 332, 1969.
Wilber J. F., Turtle J. R., Crane N. A.: Inhibition of Insulin Secretion by a Pheochromocytoma — Lancet2, 733, 1966.
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Seino, Y., Taminato, T., Kurahachi, H. et al. Comparative insulinogenic effects of glucose, arginine and glucagon in patients with diabetes mellitus, endocrine disorders and liver disease. Acta diabet. lat 12, 89–99 (1975). https://doi.org/10.1007/BF02624728
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DOI: https://doi.org/10.1007/BF02624728