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Plasma adenosine 3′:5′ — cyclic monophosphate response to glucagon in uremia

Plasmaadenosin 3′:5′ cyclisches Monophosphat, Verhalten nach Glukagonstimulation bei Urämie

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Summary

The effect of a single, intravenously administered dose of glucagon on plasma cyclic adenoside monophosphate (cAMP) was studied in seven normal subjects, ten patients with chronic renal failure (CRF), and ten patients with terminal renal insufficiency (TRI) receiving long-term haemodialysis treatment (HD). Ten minutes following glucagon administration, uremic patients displayed a significantly (P < 0.0001) greater increase in cAMP than control subjects. Glucose levels after glucagon administration did not differ significantly between the normal and uremic groups, and lipolysis was less pronounced in the uremic patients than in the controls (P < 0.003). These results could not be attributed to differences in serum insulin response. The findings demonstrate differences in the hepatic adenylate cyclase and cAMP response between normal and uremic subjects. These alterations in cAMP responsiveness may play a role in the pathophysiology of the metabolic disturbances associated with uremia.

Zusammenfassung

Vergleichend wurde der Effekt einer intravenös gegebenen Einzeldosis von Glukagon auf das Verhalten der cAMP-Konzentration im Plasma untersucht. Die Untersuchungen erfolgten an 7 gesunden Personen, 10 Patienten mit chronischer Niereninsuffizienz und 10 Patienten, die auf Grund des chronischen Nierenversagens einer Langzeithämodialysebehandlung bedurften.

10 min nach Glukagonanwendung zeigten die urämischen Patienten einen signifikanten (p < 0,0001) größeren Anstieg von cAMP im Vergleich zu der Kontrollgruppe.

Die Glukosekonzentrationen zeigten nach Glukagon zwischen den beiden Gruppen keine Differenz.

Die Lipolyse war in der urämischen Patientengruppe weniger stark ausgeprägt, als bei den Kontrollen (p < 0,003). Die Resultate ließen sich nicht auf Unterschiede in der Insulinantwort zurückführen.

Die Befunde weisen auf ein unterschiedliches Verhalten der hepatischen Adenylatcyclase und der cAMP-Bildung zwischen gesunden und urämischen Personen hin. Diese Änderungen der cAMP-Aktivität können eine grundsätzliche Rolle bei der Pathophysiologie metabolischer Störungen bei Urämie spielen.

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  1. Abteilung für Nephrologie des Zentrums der Inneren Medizin des Klinikums der J.W. Goethe-Universität, Frankfurt a.M.

    J. Vlachoyannis & W. Schoeppe

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  1. J. Vlachoyannis
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  2. W. Schoeppe
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Vlachoyannis, J., Schoeppe, W. Plasma adenosine 3′:5′ — cyclic monophosphate response to glucagon in uremia. Klin Wochenschr 60, 651–657 (1982). https://doi.org/10.1007/BF01716797

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  • DOI: https://doi.org/10.1007/BF01716797

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