OSCILLATORY INSULIN-SECRETION AFTER PANCREAS TRANSPLANT

被引:26
作者
OMEARA, NM [1 ]
STURIS, J [1 ]
BLACKMAN, JD [1 ]
BYRNE, MM [1 ]
JASPAN, JB [1 ]
ROLAND, DC [1 ]
THISTLETHWAITE, JR [1 ]
POLONSKY, KS [1 ]
机构
[1] UNIV CHICAGO,PRITZKER SCH MED,DEPT MED,MC1027,5841 S MARYLAND AVE,CHICAGO,IL 60637
关键词
D O I
10.2337/diabetes.42.6.855
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
In vivo studies of beta-cell secretory function have demonstrated the existence of rapid insulin oscillations of small amplitude recurring every 8-15 min in normal subjects. This study evaluated the effects of pancreas transplant on rapid insulin oscillations. Samples for glucose, insulin, and C-peptide were drawn during constant glucose infusion at 2-min intervals for 90 min from six successful Px patients with type I diabetes mellitus, from six normal nondiabetic control subjects, and from three Kx subjects. A computerized algorithm (ULTRA) was used for pulse detection. In the Px group, the average insulin pulse period was significantly shorter than in both the control and Kx groups (Px 8.1 +/- 0.5, control 12.5 +/- 0.7, Kx 12.4 +/- 0.5 min, P < 0.0005). By contrast, the C-peptide pulse periods (Px 16.8 +/- 2.3, control 14.7 +/- 1.2, Kx 15.3 +/- 1.5 min) were similar in the three groups. Spectral analysis confirmed that the frequency of the insulin pulses was increased in the Px group. The absolute amplitude of the insulin pulses was greater in the Px group (P < 0.001) while the amplitude of the C-peptide pulses did not differ between the groups. Cross-correlation analysis demonstrated maximal correlation coefficients at a lag of 0 min between insulin and C-peptide (control r = 0.33, P < 0.0001; Kx r = 0.17, P = 0.06) and between insulin and glucose (control r = 0.21, P < 0.001; Kx r = 0.20, P < 0.02) in the control and Kx groups, respectively, whereas no significant correlations were observed at any lag in the Px group. Thus, insulin oscillations, which are of larger amplitude and occur with greater frequency than in normal control subjects, may be detected in the peripheral circulation after pancreas transplant. Although their persistence after transplant supports the hypothesis that they reflect the existence of an intrinsic islet cell pacemaker, the increased frequency of the oscillations in the Px group raises the possibility that this intrinsic pacemaker in normal subjects may be modified by extrinsic neural factors.
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收藏
页码:855 / 861
页数:7
相关论文
共 36 条
[11]   INVITRO PANCREATIC HORMONAL PULSES ARE LESS REGULAR AND MORE FREQUENT THAN INVIVO [J].
GOODNER, CJ ;
KOERKER, DJ ;
STAGNER, JI ;
SAMOLS, E .
AMERICAN JOURNAL OF PHYSIOLOGY, 1991, 260 (03) :E422-E429
[12]   NEURAL INFLUENCES ON OSCILLATIONS IN BASAL PLASMA-LEVELS OF INSULIN IN MONKEYS [J].
HANSEN, BC ;
PEK, S ;
KOERKER, DJ ;
GOODNER, CJ ;
WOLFE, RA ;
SCHIELKE, GP .
AMERICAN JOURNAL OF PHYSIOLOGY, 1981, 240 (01) :E5-E11
[13]   RAPID OSCILLATIONS IN PLASMA-INSULIN, GLUCAGON, AND GLUCOSE IN OBESE AND NORMAL WEIGHT HUMANS [J].
HANSEN, BC ;
JEN, KLC ;
PEK, SB ;
WOLFE, RA .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1982, 54 (04) :785-792
[14]   INVIVO PULSATILITY OF PANCREATIC-ISLET PEPTIDES [J].
JASPAN, JB ;
LEVER, E ;
POLONSKY, KS ;
VANCAUTER, E .
AMERICAN JOURNAL OF PHYSIOLOGY, 1986, 251 (02) :E215-E226
[15]   CYCLIC OSCILLATIONS OF BASAL PLASMA-GLUCOSE AND INSULIN CONCENTRATIONS IN HUMAN-BEINGS [J].
LANG, DA ;
MATTHEWS, DR ;
PETO, J ;
TURNER, RC .
NEW ENGLAND JOURNAL OF MEDICINE, 1979, 301 (19) :1023-1027
[16]   BRIEF, IRREGULAR OSCILLATIONS OF BASAL PLASMA-INSULIN AND GLUCOSE-CONCENTRATIONS IN DIABETIC MAN [J].
LANG, DA ;
MATTHEWS, DR ;
BURNETT, M ;
TURNER, RC .
DIABETES, 1981, 30 (05) :435-439
[17]   DYNAMIC ASPECTS OF INSULIN ACTION - SYNCHRONIZATION OF OSCILLATORY GLYCOLYSIS IN ISOLATED PERIFUSED RAT FAT-CELLS BY INSULIN AND HYDROGEN-PEROXIDE [J].
LIPKIN, EW ;
TELLER, DC ;
DEHAEN, C .
BIOCHEMISTRY, 1983, 22 (04) :792-799
[18]   REDUCTION OF INSULIN RESISTANCE BY COMBINED KIDNEY-PANCREAS TRANSPLANTATION IN TYPE-1 (INSULIN-DEPENDENT) DIABETIC-PATIENTS [J].
LUZI, L ;
SECCHI, A ;
FACCHINI, F ;
BATTEZZATI, A ;
STAUDACHER, C ;
SPOTTI, D ;
CASTOLDI, R ;
FERRARI, G ;
DICARLO, V ;
POZZA, G .
DIABETOLOGIA, 1990, 33 (09) :549-556
[19]  
MATTHEWS DR, 1983, DIABETOLOGIA, V24, P231
[20]   GREATER INVIVO THAN INVITRO PULSATILITY OF INSULIN-SECRETION WITH SYNCHRONIZED INSULIN AND SOMATOSTATIN SECRETORY PULSES [J].
MATTHEWS, DR ;
HERMANSEN, K ;
CONNOLLY, AA ;
GRAY, D ;
SCHMITZ, O ;
CLARK, A ;
ORSKOV, H ;
TURNER, RC .
ENDOCRINOLOGY, 1987, 120 (06) :2272-2278