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Einfluß von Somatostatin auf die orale Glucosetoleranz bei autonomer Mehrsekretion von Wachstumshormon, Prolaktin oder Insulin

Influence of somatastatin on oral glucose tolerance in autonomous hypersecretion of growth hormone, prolactin or insulin

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Summary

Oral glucose tolerance tests (OGTT) were performed for two subsequent days in 4 patients with active acromegaly, 2 patients with prolactin-producing pituitary adenomas and one insulinoma patient. Thirty minutes before the second OGTT 250 µg of somatostatin were injected intravenously as a bolus followed by a somatostatin infusion (500 µg) over 2 1/2 hours. The OGTTs were pathologic due to the hGH- and hPRL-induced insulin antagonism; they could not be normalized or improved by somatostatin. Only the peak of the blood sugar curve was shifted from one to two and a half hours after glucose administration; insulin and hGH levels were regularly suppressed after somatostatin whereas hPRL remained unchanged in most instances. Gastrin levels increased in all patients during the OGTT, the increase was suppressed in 4 patients.

These findings show that the pathologic glucose tolerance due to insulin antagonism could not be improved by somatostatin in contrast to the deteriorated glucose tolerance in insulinopenic states.

Zusammenfassung

Bei 4 Patienten mit aktiver Akromegalie, 2 Patienten mit einem Prolaktin-produzierenden Hypophysentumor und einer Patientin mit einem Insulinom wurde an 2 aufeinanderfolgenden Tagen ein oraler Glucosetoleranztest (OGTT) durchgeführt. Während des 2. OGTT wurden 30 min vor Beginn der Glucosebelastung 250 µg Somatostatin als Bolus injiziert, gefolgt von einer Somatostatin-Infusion (500 µg) über 2 1/2 Std. Die durch den Wachstumshormon-bzw. Prolaktin-induzierten Insulinantagonismus bedingte pathologische Glucosebelastung konnte durch Somatostatin nicht normalisiert werden; lediglich das Blutzucker-Maximum verschob sich von 1 auf 2 1/2 Std nach Glucosegabe. Die Insulin- und Wachstumshormonspiegel wurden durch Somatostatin supprimiert, die Prolaktinspiegel hingegen verhielten sich variabel. Der bei allen Patienten beobachtete glucoseinduzierte Anstieg des Serum-Gastrins wurde in 4 Fällen durch Somatostatin gehemmt.

Diese Befunde zeigen, daß die pathologische Glucosetoleranz bei Insulinantagonismus im Gegensatz zu der bei Insulinmangel durch Somatostatin nicht wesentlich beeinflußt werden kann.

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Literatur

  1. Alberti, K.G.M.M., Christensen, N.J., Christensen, S.E., Prange-Hansen, A.A., Iversen, J., Lundbaek, K., Seyer-Hansen, K., Ørskov, H.: Inhibition of insulin secretion by somatostatin. LancetII, 1299 (1973)

    Google Scholar 

  2. Arnold, R., Fuchs, K., Siewert, K., Peiper, H.-J., Creutzfeldt, W.: Zur Morphologie, Klinik, Diagnostik und Therapie des Zollinger-Ellison-Syndroms. Dtsch. med. Wschr.99, 607 (1974)

    Google Scholar 

  3. Benker, G., Reinwein, D.: Somatostatin. Dtsch. med. Wschr.100, 961 (1975)

    Google Scholar 

  4. Besser, G.M., Mortimer, C.H., Carr, D., Schally, A.V., Coy, D.H., Evered, D., Kastin, A.J., Tunbridge, W.M.G., Thorner, M.O., Hall, R.: Growth hormone release inhibiting hormone in acromegaly. Brit. med. J.1, 352 (1974)

    Google Scholar 

  5. Besser, G.M., Mortimer, C.H., McNeilly, A.S., Thorner, M.O., Batistoni, G.A., Bloom, S.R., Katrup, K.W., Hansen, K.F., Hall, R., Coy, D.H., Kastin, A.J., Schally, A.V.: Long term infusion of growth hormone release inhibiting hormone in acromegaly. Effects on pituitary and pancreatic hormones. Brit. med. J.4, 622 (1974)

    Google Scholar 

  6. Bloom, S.R., Mortimer, C.H., Thorner, M.O., Besser, G.M., Hall, R., Gomez-Pan, R., Roy, V.M., Russell, R.C.G., Coy, D.H., Kastin, A.J., Schally, A.V.: Inhibition of gastrin and gastric acid secretion by growth hormone release inhibiting hormone. LancetII, 1106 (1974)

    Google Scholar 

  7. Brazeau, P., Vale, W., Burgus, R., Ling, N., Butcher, M., Rivier, J., Guillemin, R.: Hypothalamic peptide that inhibits the secretion of immunoreactive pituitary growth hormone. Science179, 77 (1973)

    Google Scholar 

  8. Creutzfeldt, W., Arnold, R., Creutzfeldt, C., Feuerle, G., Ketterer, H.: Gastrin and G-cells in the antral mucosa of patients with pernicious anemia, acromegaly, and hypoparathyroidism, and in a Zollinger-Ellison tumor of the pancreas. Europ. J. Clin. Invest.1, 461 (1971)

    Google Scholar 

  9. DeVane, 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)

    Google Scholar 

  10. Diabetes Mellitus — Report of a WHO Expert Commitee. WHO, Techn. Report Ser. No. 310, 1965

  11. Gerich, J.E., Lorenzi, M., Hane, S., Gustafson, G., Guillemin, R., Forsham, P.H.: Evidence for a physiological role of pancreatic glucagon in human glucose homeostasis studies with somatostatin. Metab.24, 175 (1975)

    Google Scholar 

  12. Hales, C.N., Randle, P.J.: Immunoassay for insulin with insulin antibody-precipitate. Biochem. J.88, 137 (1968)

    Google Scholar 

  13. Hall, R., Schally, A.V., Evered, D., Kastin, A.J., Mortimer, C.H., Tunbridge, W.M.G., Besser, G.M., Coy, D.M., Goldie, D.J., McNeilly, A.S., Phenekos, C., Weightman, D.: Action of growth hormone release inhibiting hormone in healthy men and in acromegaly. LancetII, 581 (1973)

    Google Scholar 

  14. Koerker, D.J., Ruch, W., Chideckel, E., Palmer, J., Goodner, C.J., Eusinck, J.W., Gale, C.C.: Somatostatin: Hypothalamic inhibitor of the endocrine pancreas. Science184, 482 (1974)

    Google Scholar 

  15. Korman, M.G., Soveny, C., Hansky, J.: Effect of food on serum gastrin evaluated by radioimmunoassay. Gut12, 619 (1971)

    Google Scholar 

  16. Landgraf, R., Weissmann, A., Landgraf-Leurs, M., v. Werder, K.: Glucose tolerance and glucose-induced insulin release in patients with hyper-prolactinemia. Acta endocr. (Kbh.) Suppl.193, 65 (1975)

    Google Scholar 

  17. Levine, R., Haft, D.E.: Carbohydrate homeostasis. New Engl. J. Med.283, 175 (1970)

    Google Scholar 

  18. Londong, W., Geier, E., Feifel, G., Forell, M.M.: Hypoglykämie-induzierte Gastrinfreisetzung nach Vagotomie. Z. Gastroenterol.13, 418 (1975)

    Google Scholar 

  19. Lorenzi, M., Karam, J.H., Forsham, P.H.: Somatostatin as a diagnostic aid in insulinoma. 57th annual meeting of The Endocrine Society, New York, June 18–20, 1975

  20. Luft, R., Cerasi, E., Hamberger, C.A.: Studies on the pathogenesis of diabetes in acromegaly. Acta endocr. (Kbh.)56, 593 (1967)

    Google Scholar 

  21. Mortimer, C.H., Carr, D., Lind, T., Bloom, S.R., Mallison, C.N., Schally, A.V., Tunbridge, W.M.G., Yeomans, L., Coy, D.H., Kastin, A.J., 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. LancetI, 697 (1974)

    Google Scholar 

  22. Prange-Hansen, A., Ørskov, H., Seyer-Hansen, K., Lundbaek, K.: Some actions of growth hormone release inhibiting factor. Brit. Med. J.3, 523 (1973)

    Google Scholar 

  23. Rehfeld, J.F., Stadil, F.: The glucose-induced gastrointestinal stimulation of insulin secretion in man: Relation to age and to gastrin release. Europ. J. Clin. Invest.5, 273 (1975)

    Google Scholar 

  24. Sakurai, H., Unger, R.: Effects of somatostatin on insulin and glucagon and insulin/glucagon ratio in normal and diabetic dogs. Diabetes23, Suppl. 1, 337 (1974)

    Google Scholar 

  25. Siler, T.M., Vandenberg, G., Yen, S.S.C., Brazeau, P., Vale, W., Guillemin, R.: Inhibition of growth hormone release in humans by somatostatin. J. Clin. Endocr.37, 632 (1973)

    Google Scholar 

  26. Sönksen, P.H., Greenwood, F.C., Ellis, J.P., Lowy, C., Rutherford, A., Nabarro, J.D.N.: Changes of carbohydrate tolerance in acromegaly with progress of the disease and in response to treatment. J. Clin. Endocr.27, 1418 (1967)

    Google Scholar 

  27. Thyrell, J.B., Lorenzi, M., Forsham, P.H., Gerich, J.E.: The effect of somatostatin on secretion of adrenocorticotropin in normal subjects and in patients with Nelson's syndrome and Cushing's disease. 57th annual meeting of The Endocrine Society, New York, June 18–20, 1975

  28. Werder, K., von: Wachstumshormone und Prolaktinsekretion des Menschen. Physiologie und Pathophysiologie. Urban und Schwarzenberg, München-Berlin-Wien, 1975

    Google Scholar 

  29. Werder, K., von, Clemm, C., Kerner, W., Scriba, P.C.: A hPRL-RIA using antibodies against the “little” component of serum-hPRL. 57th annual meeting of The Endocrine Society, New York, June 18–20, 1975

  30. Yen, S.S.C., Siler, T.M., DeVane, G.W.: Effects of somatostatin in patients with acromegaly: Suppression of growth hormone, prolactin, insulin and glucose levels. New Engl. J. Med.290, 935 (1974)

    Google Scholar 

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Authors and Affiliations

  1. II. Medizinische Klinik der Universität München, Germany

    M. Gottsmann, R. Landgraf, W. Londong & K. v. Werder

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  1. M. Gottsmann
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  2. R. Landgraf
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  3. W. Londong
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  4. K. v. Werder
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Gottsmann, M., Landgraf, R., Londong, W. et al. Einfluß von Somatostatin auf die orale Glucosetoleranz bei autonomer Mehrsekretion von Wachstumshormon, Prolaktin oder Insulin. Klin Wochenschr 53, 1161–1166 (1975). https://doi.org/10.1007/BF01476456

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