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JCEM：全胰切除术/胰岛自体移植受者中混合餐时胰高血糖素对低血糖的反应不足

2018-01-21 MedSci MedSci原创

全胰切除术/胰岛自体移植胰高血糖素低血糖
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大家都知道全胰切除术和肝内胰岛自体移植（TP / IAT）可以缓解严重腹痛，避免麻醉药使用，保持胰岛功能，并且避免慢性胰腺炎患者的糖尿病发生。然而，许多接受TP / IAT治疗的患者抱怨餐后低血糖。近日在JCEM上发表的一篇文章则旨在研究这一发生机制。

大家都知道全胰切除术和肝内胰岛自体移植（TP / IAT）可以缓解严重腹痛，避免麻醉药使用，保持胰岛功能，并且避免慢性胰腺炎患者的糖尿病发生。然而，许多接受TP / IAT治疗的患者抱怨餐后低血糖。近日在JCEM上发表的一篇文章则旨在研究这一发生机制。

研究者纳入了10个TP / IAT和10个年龄及BMI匹配的对照受试者。 10名受试者中有7人有餐后低血糖史。给予受试者[1-13C]标记的混合餐和两种示踪剂输注（[6，6-2H2] - 和[6-3H] - 葡萄糖）。主要的测量结果是测定葡萄糖动力学和调节激素的浓度。

与对照组相比，TP / IAT受试者刚进餐后高峰葡萄糖升高（266±20mg / dl [14.8±1.1mmol / l]vs185±13mg / dl [10.3±0.7mmol / l]； p = 0.01）。然而，其餐后240-360分钟的平均δ葡萄糖显着低于对照组（p <0.05）；7名有低血糖史的受试者中6名经历了异常低的餐后δ葡萄糖。重要的是，尽管餐后血糖异常降低，但TP / IAT受试者中Δ胰高血糖素保持不变（最小240-360； p = 0.58）。放射性同位素研究显示，TP / IAT受者的膳食外观，葡萄糖消失和内源性葡萄糖产生与对照组没有差异。

上述研究结果表明最初高葡萄糖水平，然后低血糖，胰高血糖素反应缺失是一个机械序列，最终导致TP / IAT受试者的餐后低血糖。

原始出处：

L D Bogachus.et al. Deficient glucagon response to hypoglycemia during a mixed meal in total pancreatectomy/islet autotransplantation recipients. J Clin Endocrinol Metab. 2017.

本文系梅斯医学（MedSci）原创编译整理，转载需授权！

本文系梅斯医学（MedSci）原创编译整理，转载需授权！
本文系梅斯医学（MedSci）原创编译整理，转载需授权！
轻灵划译
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    2018-12-13 smallant2015

    #JCEM#

    0

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    2018-03-17 achengzhao

    #JCE#

    0

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    2018-05-10 doctorzheng

    #切除术#

    0

  4. 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style='color:#2F92EE;'>#自体移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86005, encryptionId=b64f8600524, topicName=自体移植)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa1d8667340, createdName=jxrzshh, createdTime=Tue Jan 23 08:55:00 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281162, encodeId=71d728116246, content=学习并分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Tue Jan 23 07:22:06 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280978, encodeId=b3632809e8d0, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Jan 22 13:10:18 CST 2018, time=2018-01-22, status=1, ipAttribution=)]
    2018-02-21 baoya

    #胰岛#

    0

  5. 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style='color:#2F92EE;'>#自体移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86005, encryptionId=b64f8600524, topicName=自体移植)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa1d8667340, createdName=jxrzshh, createdTime=Tue Jan 23 08:55:00 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281162, encodeId=71d728116246, content=学习并分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Tue Jan 23 07:22:06 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280978, encodeId=b3632809e8d0, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Jan 22 13:10:18 CST 2018, time=2018-01-22, status=1, ipAttribution=)]
    2018-01-31 大爰

    学习了谢谢分享!!

    0

  6. 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style='color:#2F92EE;'>#自体移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86005, encryptionId=b64f8600524, topicName=自体移植)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa1d8667340, createdName=jxrzshh, createdTime=Tue Jan 23 08:55:00 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281162, encodeId=71d728116246, content=学习并分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Tue Jan 23 07:22:06 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280978, encodeId=b3632809e8d0, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Jan 22 13:10:18 CST 2018, time=2018-01-22, status=1, ipAttribution=)]
    2018-01-23 hbwxf

    #高血糖#

    0

  7. 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replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102726, encryptionId=30c6102e2607, topicName=高血糖)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Tue Jan 23 08:55:00 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457620, encodeId=5039145e62075, content=<a href='/topic/show?id=72148400568' target=_blank style='color:#2F92EE;'>#胰高血糖素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84005, encryptionId=72148400568, topicName=胰高血糖素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b38f5964248, createdName=sjzlzc009, createdTime=Tue Jan 23 08:55:00 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490024, encodeId=456a149002434, content=<a href='/topic/show?id=b64f8600524' target=_blank style='color:#2F92EE;'>#自体移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86005, encryptionId=b64f8600524, topicName=自体移植)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa1d8667340, createdName=jxrzshh, createdTime=Tue Jan 23 08:55:00 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281162, encodeId=71d728116246, content=学习并分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Tue Jan 23 07:22:06 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280978, encodeId=b3632809e8d0, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Jan 22 13:10:18 CST 2018, time=2018-01-22, status=1, ipAttribution=)]
    2018-01-23 sjzlzc009

    #胰高血糖素#

    0

  8. 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createdBy=e656479, createdName=achengzhao, createdTime=Sat Mar 17 18:55:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1876982, encodeId=d4c218e6982f4, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Thu May 10 17:55:00 CST 2018, time=2018-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1749910, encodeId=9c681e499105c, content=<a href='/topic/show?id=be7c8385345' target=_blank style='color:#2F92EE;'>#胰岛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83853, encryptionId=be7c8385345, topicName=胰岛)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a7a536274692, createdName=baoya, createdTime=Wed Feb 21 03:55:00 CST 2018, time=2018-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283759, encodeId=81f4283e5901, content=学习了谢谢分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Wed Jan 31 07:26:03 CST 2018, time=2018-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1261141, encodeId=b38b1261141ad, content=<a href='/topic/show?id=30c6102e2607' target=_blank style='color:#2F92EE;'>#高血糖#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102726, encryptionId=30c6102e2607, topicName=高血糖)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Tue Jan 23 08:55:00 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457620, encodeId=5039145e62075, content=<a href='/topic/show?id=72148400568' target=_blank style='color:#2F92EE;'>#胰高血糖素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84005, encryptionId=72148400568, topicName=胰高血糖素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b38f5964248, createdName=sjzlzc009, createdTime=Tue Jan 23 08:55:00 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490024, encodeId=456a149002434, content=<a href='/topic/show?id=b64f8600524' target=_blank style='color:#2F92EE;'>#自体移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86005, encryptionId=b64f8600524, topicName=自体移植)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa1d8667340, createdName=jxrzshh, createdTime=Tue Jan 23 08:55:00 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281162, encodeId=71d728116246, content=学习并分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Tue Jan 23 07:22:06 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280978, encodeId=b3632809e8d0, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Jan 22 13:10:18 CST 2018, time=2018-01-22, status=1, ipAttribution=)]
    2018-01-23 jxrzshh

    #自体移植#

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1777752, encodeId=e5c31e777528c, content=<a href='/topic/show?id=eb9610265ed' target=_blank style='color:#2F92EE;'>#JCEM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10265, encryptionId=eb9610265ed, topicName=JCEM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2a4439169927, createdName=smallant2015, createdTime=Thu Dec 13 19:55:00 CST 2018, time=2018-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2063134, encodeId=e983206313422, content=<a href='/topic/show?id=14fb10264d7' target=_blank style='color:#2F92EE;'>#JCE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10264, encryptionId=14fb10264d7, topicName=JCE)], attachment=null, authenticateStatus=null, createdAvatar=, 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replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102726, encryptionId=30c6102e2607, topicName=高血糖)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Tue Jan 23 08:55:00 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457620, encodeId=5039145e62075, content=<a href='/topic/show?id=72148400568' target=_blank style='color:#2F92EE;'>#胰高血糖素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84005, encryptionId=72148400568, topicName=胰高血糖素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b38f5964248, createdName=sjzlzc009, createdTime=Tue Jan 23 08:55:00 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490024, encodeId=456a149002434, content=<a href='/topic/show?id=b64f8600524' target=_blank style='color:#2F92EE;'>#自体移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86005, encryptionId=b64f8600524, topicName=自体移植)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa1d8667340, createdName=jxrzshh, createdTime=Tue Jan 23 08:55:00 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281162, encodeId=71d728116246, content=学习并分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Tue Jan 23 07:22:06 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280978, encodeId=b3632809e8d0, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Jan 22 13:10:18 CST 2018, time=2018-01-22, status=1, ipAttribution=)]
    2018-01-23 大爰

    学习并分享!!

    0

  10. 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createdBy=e656479, createdName=achengzhao, createdTime=Sat Mar 17 18:55:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1876982, encodeId=d4c218e6982f4, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Thu May 10 17:55:00 CST 2018, time=2018-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1749910, encodeId=9c681e499105c, content=<a href='/topic/show?id=be7c8385345' target=_blank style='color:#2F92EE;'>#胰岛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83853, 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style='color:#2F92EE;'>#自体移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86005, encryptionId=b64f8600524, topicName=自体移植)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aa1d8667340, createdName=jxrzshh, createdTime=Tue Jan 23 08:55:00 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281162, encodeId=71d728116246, content=学习并分享!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Tue Jan 23 07:22:06 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280978, encodeId=b3632809e8d0, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Mon Jan 22 13:10:18 CST 2018, time=2018-01-22, status=1, ipAttribution=)]
    2018-01-22 虈亣靌

    是很好的学习材料.不错.以后会多学习.

    0

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