Peripheral Insulin Release after Pancreatic Resection: The Effect of Decreased β-Cell Mass with Systemic or Portal Drainage*
| Autor: | Dariush Elahi, Kenneth B. Brown, David A. Krusch, Donald L. Kaiser, John B. Hanks, Arthur E. Freedlender, Philo Calhoun |
|---|---|
| Rok vydání: | 1988 |
| Předmět: |
Blood Glucose
medicine.medical_specialty medicine.medical_treatment Biology Islets of Langerhans Dogs Pancreatectomy Endocrinology Reference Values Internal medicine Insulin Secretion medicine Animals Insulin Pancreatic hormone Glucose tolerance test medicine.diagnostic_test Glucose Tolerance Test Autotransplantation Portal System medicine.anatomical_structure Basal (medicine) Female Pancreas Hyperglycemic agent |
| Zdroj: | Endocrinology. 123:426-432 |
| ISSN: | 1945-7170 0013-7227 |
| DOI: | 10.1210/endo-123-1-426 |
| Popis: | Surgical alteration of the pancreas can result in several anatomic alterations which may affect insulin release. We evaluated the effects of resection, systemic drainage, and autotransplantation of the canine pancreas on peripheral insulin levels and glucose disposal as measured by iv glucose tolerance tests (IVGTT) and a steady state hyperglycemic challenge (clamp). Proximal pancreatectomy (PPx) with reduced beta-cell mass and intact portal drainage resulted in a modestly elevated fasting glucose level and increased integrated glucose response to IVGTT. Compared to preoperative normals, basal insulin was unchanged from preoperative controls; however, peak insulin and integrated insulin response to IVGTT were decreased in PPx animals. Splenocaval drainage or autotransplantation of the distal pancreas resulted in normalization of the severely altered insulin response and fasting glucose levels. K values were significantly reduced after all three procedures. Clamp studies confirmed the basal glucose and insulin findings of the IVGTT. During the clamp, PPx animals had peripheral insulin values approximately 50% of normal controls, while autotransplantation and splenocaval drainage animals had insulin values that approximate normal controls. All three postsurgical groups had blunted insulin levels during stable hyperglycemia. Glucose utilization rates were severely decreased in all three groups. Reduction of beta-cell mass with intact portal drainage resulted in reduced insulin response to glucose challenge by either IVGTT or clamp. Systemic drainage of this same reduced beta-cell mass resulted in peripheral insulin levels comparable to normal controls. Denervation (autotransplantation) had little additive effect. All three groups demonstrated severely decreased rates of glucose disappearance as measured by both IVGTT and clamp studies. Therefore, reduction in beta-cell mass, drained systemically or portally, results in altered glucose disposal regardless of the peripheral insulin levels. |
| Databáze: | OpenAIRE |
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