Glycine負荷法に関する臨床的研究-正常者, 甲状腺機能亢進症, 原発性甲状腺機能低下症及び胃部分切除術施行例について-(そのI) Gastrin分泌に関する知見
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It has been well known that glycine stimulates the gastric G-cells directly and/or indirectly to secrete gastrin into the blood in normal subjects and in those suffering from diseases such as stomach or duodenal ulcers, stomach cancer, pernicious anemia, liver disease, Zollinger-Ellison's syndrome etc. However, it is little known how thyroid hormones might influence the activity of gastric G-cells to secrete gastrin into the blood stream. In the present study, therefore, the response-pattern of serum gastrin to glycine administration in subjects with both hyperthyroidism and hypothyroidism was compared with that in normal subjects. We also measured the concentration of serum growth hormone (HGH) and then found that the glycine was absorbed in the gastro-intestinal canals and would reach the pituitary gland to stimulate HGH secretion.<BR>The present paper deals also with the effect of glycine on the HGH secretion of the pituitary gland in normal subjects, and those suffering from hyperthyroidism and hypothyroidism. The serum concentrations of gastrin during the fasting time were 57 ± 1 pg/ml in 50 normal subjects, 141 ± 8 pg/ml in 31 subjects with hyperthyroidism, and 49 ± 5 pg/ml in 12 subjects with hypothyroidism.<BR>Among the normal subjects, the concentrations of serum gastrin were clearly increased biphasically at 5 and 150 minutes after the peroral administration of 250 ml of 0.3M glycine dissolved in physiological saline. Among those suffering from hyperthyroidism, although the early time increase of the serum gastrin at 5 minutes was observed as similar to that among normal subjects, the second peak of serum gastrin which was observed in the normal subjects at 150 minutes after the glycine was administered was not noticed among the subjects with hyperthyroidism. On the other hand, no increase of serum gastrin concentration among patients suffering from hypothyroidism was observed at any time after the glycine administration. As would be expected, a slight increase of serum gastrin among patients with partial gastrectomy (Billroth-I) was observed only at 5 minutes after the administration of glycine.<BR>A significant increase of HGH in the serum of normal subjects, subjects suffering from hyperthyroidism and patients with partial gastrectomy was observed at 120 minutes after the administration of glycine but not among those with hypothyroidism. This effect of glycine on the pituitary to secrete HGH appeared much more clearly among patients with partial gastrectomy than in other groups, indicating that glycine could be absorbed in the upper part of the intestine more easily than in the stomach. Since no changes in the blood sugar and IRI (Immunoreactive Insulin) of any of the patients, including normal subjects, were noticed with the glycine administration, the glycine absorbed by the intestine would appear to reach the pituitary and/or the anterior hypothalamus stimulating the secretion of HGH from the pituitary gland.
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