Summary
The present study was performed in order to evaluate the plasma glucose pattern in cirrhotic patients who, in the course of a continuous somatostatin infusion (500 µg/h), were given pulses of glucagon (1 mg i.v.). In normal as well as in cirrhotic subjects somatostatin infusion provoked a marked reduction of the IRI plasma level and this was uninfluenced by subsequent glucagon administration. The rise in plasma glucose level in response to i.v. glucagon administration during somatostatin infusion was less marked in cirrhotics compared to normal subjects. This can be attributed to a variety of factors such as reduced number of liver cells or quantitative or qualitative changes of the liver cell glucagon receptors. Glucagon does not seem to contribute to the pathogenesis of carbohydrate intolerance in liver cirrhosis.
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Alberti K. G. M. M., Christensen N. J., Christensen S. E., Hansen P. Aa., Iversen J., Lundbæk K., Seyer-Hansen K., Ørskov H.: Inhibition of insulin secretion by somatostatin — Lancet2, 1299, 1973.
Alford F. P., Bloom S. R., Nabarro J. D. N., Hall R., Besser G. M., Coy D. H., Kastin A. J., Schally A. V.: Glucagon control of fasting glucose in man — Lancet2, 974, 1974.
Altszuler N., Gottlieb B., Hampshire J.: Interaction of somatostatin, glucagon and insulin on hepatic glucose output in the normal dog — Diabetes25, 116, 1976.
Christensen S. E., Hansen P. Aa., Iversen J., Lundbæk K., Ørskov H., Seyer-Hansen K.: Somatostatin as a tool in studies of basal carbohydrate and lipid metabolism in man: modifications of glucagon and insulin release — Scand. J. clin. Lab. Invest.34, 321, 1974.
Danowski T. S., Gillespie H. K., Fergus E. B.: Significance of blood sugar and serum electrolyte changes in cirrhosis following glucose, insulin, glucagon or epinephrine — Yale J. Biol. Med.29, 361, 1956.
De Moura M. C., Cruz A. G.: Carbohydrate metabolism studies in cirrhosis of the liver — Amer. J. dig. Dis.13, 891, 1968.
De Vane G. W., Siler T. M., Yen S. S. C.: Acute suppression of insulin and glucose levels by synthetic somatostatin in normal human subjects — J. clin. Endocr.38, 913, 1974.
Felig P., Wahren J., Sherwin R., Hendler R.: Insulin, glucagon and somatostatin in normal physiology and diabetes mellitus — Diabetes25, 1091, 1976.
Gerich J. E.: Somatostatin. Its possible role in carbohydrate homeostasis and the treatment of diabetes mellitus — Arch. intern. Med.137, 659, 1977.
Gerich J. E., Lorenzi M., Hane S., Gustafson G., Forsham P. H.: Evidence for a physiologic role of pancreatic glucagon in human glucose homeostasis: studies with somatostatin — Metabolism24, 175, 1975.
Gerich J. E., Lorenzi M., Schneider V., Karam J. H., Rivier J., Guillemin R., Forsham P. H.: Effects of somatostatin on plasma glucose and glucagon levels in human diabetes mellitus. Pathophysiologic and therapeutic implications — New Engl. J. Med.291, 544, 1974.
Ghirlanda G., Manna R., Rebuzzi A. G., Altomonte L., Greco A. V.: Variazioni dell’insulina e del GH plasmatici dopo glucagone endovena nella cirrosi epatica — Minerva med.67, 3187, 1976.
Greco A. V., Fedeli G., Ghirlanda G., Manna R., Patrono C.: Behavior of pancreatic glucagon, insulin and HGH in liver cirrhosis, after arginine and i.v. glucose — Acta diabet. lat.11, 330, 1974.
Herbert V., Lau K. S., Gottlieb C. W., Bleicher S. J.: Coated charcoal immunoassay of insulin — J. clin. Endocr.25, 1375, 1965.
Johnston D. C., Alberti K. G. M. M., Faber O. K., Binder C., Wright R.: Hyperinsulinism of hepatic cirrhosis: diminished degradation or hypersecretion? — Lancet1, 10, 1977.
Koerker D. J., Ruch W., Chideckel E., Palmer J., Goodner C. J., Ensinck J. W., Gale C. C.: Somatostatin: hypothalamic inhibitor of the endocrine pancreas — Science184, 482, 1974.
Mallinson C. N., Bloom S. R., Warin A. P., Salmon P. R., Cox B.: A glucagonoma syndrome — Lancet2, 1, 1974.
Marco J., Diego J., Villanueva M. L., Diaz-Fierros M., Valverde I., Segovia J. M.: Elevated plasma glucagon levels in cirrhosis of the liver — New Engl. J. Med.289, 1107, 1973.
Mortimer C. H., Carr D., Lind T., Bloom S. R., Mallinson C. N., Schally A. V., Tunbridge W. M. G., Yeomans L., Coy D. H., Kastin A., Besser G. M., Hall R.: Effects of growth-hormone release-inhibiting hormone on circulating glucagon, insulin and growth hormone in normal, diabetic, acromegalic, and hypopituitary patients — Lancet1, 697, 1974.
Sherwin R. S., Felig P.: Glucagon and blood sugar — New Engl. J. Med.294, 1238, 1976.
Sherwin R. S., Fisher M., Hendler R., Felig P.: Hyperglucagonemia and blood regulation in normal, obese, and diabetic subjects — New Engl. J. Med.294, 455, 1976.
Sherwin R. S., Joshi P., Hendler R., Felig P., Conn H. O.: Hyperglucagonemia in Laennec’s cirrhosis: the role of portal-systemic shunting — New Engl. J. Med.290, 239, 1974.
Shurberg J. L., Resnick R. H., Koff R. S., Ros E., Baum R. A., Pallotta J. A.: Serum lipids, insulin, and glucagon after portacaval shunt in cirrhosis — Gastroenterology72, 301, 1977.
Waldhäusl W., Bratusch-Marrain P., Dudczak R., Deutsch E.: The diabetogenic action of somatostatin in healthy subjects and in maturity onset diabetics — J. clin. Endocr.44, 876, 1977.
Yen S. S. C., Siler T. M., De Vane G. W.: Effect of somatostatin in patients with acromaegaly. Suppression of growth hormone, prolactin, insulin and glucose levels — New Engl. J. Med.290, 935, 1974.
Yeung R. T. T., Wang C. C. L.: A study of carbohydrate metabolism in post necrotic cirrhosis of liver — Gut15, 907, 1974.
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Altomonte, L., Rebuzzi, A.G., Greco, A.V. et al. Effect of somatostatin (SRIF) on plasma glucose and insulin response to glucagon in liver cirrhosis. Acta diabet. lat 16, 139–145 (1979). https://doi.org/10.1007/BF02581093
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DOI: https://doi.org/10.1007/BF02581093