Pancreatic polypeptide 分泌動態の生理学的並びに病理学的意義に関する研究、とくに膵インスリン分泌との相関を中心として
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The effects of blood glucose and insulin on the human pancreatic polypeptide (hPP) secretion response in healthy subjects and diabetics (IDDM and NIDDM) were studied, and the pathological significance of the mechanism of hPP secretion was examined. 1) Healthy subjects were given a sustained drip infusion of saline, 10% or 20% glucose at the rate of 4.2ml/min for two hours. One hour after the infusion, a test meal was given and the hPP secretion response was observed. At the early first response the hPP response was 26.6±8.8 ng/min/ml in the control group to which physiological saline had been injected, 18.1±5.7 ng/min/m! in the group that had been injected with 10% glucose and 12.3±4.1 ng/min/ml in the group that had received 20% glucose. This indicates that the hPP resopnse decreases significantly in inverse proportion to the dosage of glucose injected. The insulin secretion response, which was simultaneously measured, was markedly elevated ; it was greater than the sum of the response with the glucose infusion and that with the test meal. The change in the blood glucose level after the test meal, however, was not statistically significant. 2) A single injection of glucose was given to healthy subjects. While blood glucose and insulin levels increased markedly, the hPP response was significantly suppressed ; 110±31 pg/ml before the injection and 65±9 pg/ml 30 minutes afterwards. The hPP response after an intravenous injection of insulin was also significantly suppressed: 95±10 pg/ml before the injection and 63±11 pg/ml 20 minutes later. The hPP value increased after this as a reaction to hypoglycemia. 3) The hPP response after the test meal of IDDM's who were not treated with insulin was statistically significantly higher than that of the healthy subjects of similar ages (total hPP response : IDDM=120±24, healthy subjects = 72±5ng/min/ml). The plasma hPP level of the IDDM's after fasting was higher than that of the healthy subjects, but, after the injection of insulin, the level decreased significantly to that of the healthy subjects : 222±67 pg/ml before the injection and 132±45 pg/ml 20 minutes after the injection. 4) In NIDDM's who were well controlled with diet and hypoglycemic agents treatmemt, the hPP secretion which was initially elevated, tended to become closer to the level of the healthy subjects as the insulin secretion response to glucose restored. The above results indicate that hPP secretion is influenced by endogenous and exogenous insulin. They further suggest that some of the cases of hPP secretion abnormality observed in diabetics may be caused by insufficient secretion of insulin.
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