Aldosterone excess may inhibit insulin secretion: A comparative study on glucose metabolism pre- and post-adrenalectomy in patients with primary aldosteronism

beta-Cell function and glucose metabolism were studied in eight insulin-dependent diabetic recipients of combined segmental pancreas and kidney transplant with peripheral insulin delivery (Px), in eight nondiabetic kidney-transplant individuals (Kx), and in eight normal subjects (Ns) after three consecutive mixed meals. All subjects had normal fasting plasma glucose, but increased basal levels of C-peptide were demonstrated in the transplant groups (P < 0.05 relative to Ns). Postprandial hyperglycemia was increased 14% in Kx and 32% in Px (P < 0.05), whereas compared with Ns postprandial C-peptide levels were increased three- and twofold, respectively, in Kx and Px (P < 0.05). Compared with Ns basal insulin secretion rate (combined model) was increased 2-fold in Kx and 1.4-fold in Px (P < 0.05). Maximal insulin secretion rate was reduced 25% in Px compared with Kx (P < 0.05) but not different from that of Ns (P NS). Also, maximal insulin secretion rate occurred later in Px than in controls (Tmax: Px 50 min, Kx 30 min, and Ns 32 min; P < 0.05). The total integrated insulin secretion was increased 1.4-fold in Px compared with Ns (P < 0.05) but decreased 1.4-fold compared with Kx (P < 0.05). Fasting and postprandial proinsulin-to-C-peptide molar ratios were inappropriately increased in Px compared with Kx and Ns. Basal hepatic glucose production was increased 43% in Px and 33% in Kx compared with Ns (P < 0.05). Postprandial total systemic glucose appearance was similar in all three groups, whereas peripheral glucose disposal was 15% reduced in Px (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Download Full-text

The effect of starvation on insulin secretion and glucose metabolism in mouse pancreatic islets

Biochemical Journal ◽

10.1042/bj1400423 ◽

1974 ◽

Vol 140 (3) ◽

pp. 423-433 ◽

Cited By ~ 52

Author(s):

Carl J. Hedeskov ◽

Kirsten Capito

Keyword(s):

Insulin Secretion ◽

Glucose Metabolism ◽

Pancreatic Islets ◽

Glucose Utilization ◽

Secretory Response ◽

Secretory Process ◽

Fed State ◽

Lactate Output ◽

Extracellular Glucose ◽

Km Value

1. Rates of insulin secretion, glucose utilization, lactate output, incorporation of glucose into glycogen, contents of glucose 6-phosphate, fructose 1,6-diphosphate and ATP, and maximally extractable enzyme activities of hexokinase, high-Km glucose-phosphorylating activity (`glucokinase'), glucose 6-phosphatase and unspecific acid phosphatase were measured in isolated pancreatic islets from fed and 48-h-starved mice. 2. In the fed state insulin secretion from isolated islets was increased five- to six-fold when the extracellular glucose concentration was raised from 2.5mm to 16.7mm; 5mm-caffeine potentiated this effect. The secretory response to glucose of islets from mice starved for 48h was diminished at all glucose concentrations from 2.5mm up to approx. 40mm. Very high glucose concentrations (60mm and above) restored the secretory response to that found in the fed state, suggesting that the Km value for the overall secretory process had been increased (approx. fourfold) by starvation. Addition of 5mm-caffeine to islets from starved mice also restored the insulin secretory response to 2.5–16.7mm-glucose to normal values. 3. Extractable hexokinase, `glucokinase', glucose 6-phosphatase and unspecific phosphatase activities were not changed by starvation. 4. Glucose utilization and glycolysis (measured as the rate of formation of 3H2O from [5-3H]glucose over a 2h period) was decreased in islets from starved mice at all glucose concentrations up to approx. 55mm. At still higher glucose concentrations up to approx. 100mm, there was no difference between the fed and starved state, suggesting that the Km value for the rate-limiting glucose phosphorylation had been increased (approx. twofold) by starvation. Preparation of islets omitting substrates (glucose, pyruvate, fumarate and glutamate) from the medium during collagenase treatment lowered the glucose utilization measured subsequently at 16.7mm-glucose by 38 and 30% in islets from fed and starved mice respectively. Also the 2h lactate output by the islets at 16.7mm extracellular glucose was diminished by starvation. Incorporation of glucose into glycogen was extremely low, but the rate of incorporation was more than doubled by starvation. 5. After incubation for 30min at 16.7mm-glucose the content of glucose 6-phosphate was unchanged by starvation, that of ATP was increased and the concentration of (fructose 1,6-diphosphate plus triose phosphates) was decreased. 6. Possible mechanisms behind the correlated impairment in insulin secretion and islet glucose metabolism during starvation are discussed.

Download Full-text

Regulation of glucokinase in pancreatic islets by prolactin: a mechanism for increasing glucose-stimulated insulin secretion during pregnancy

Journal of Endocrinology ◽

10.1677/joe-07-0043 ◽

2007 ◽

Vol 193 (3) ◽

pp. 367-381 ◽

Cited By ~ 55

Author(s):

Anthony J Weinhaus ◽

Laurence E Stout ◽

Nicholas V Bhagroo ◽

T Clark Brelje ◽

Robert L Sorenson

Keyword(s):

Insulin Secretion ◽

Glucose Metabolism ◽

Pancreatic Islets ◽

Glucose Transporter ◽

Β Cells ◽

Glucose Transporter 2 ◽

Underlying Mechanisms ◽

Glucose Stimulated Insulin Secretion ◽

Induced Changes

Glucokinase activity is increased in pancreatic islets during pregnancy and in vitro by prolactin (PRL). The underlying mechanisms that lead to increased glucokinase have not been resolved. Since glucose itself regulates glucokinase activity in β-cells, it was unclear whether the lactogen effects are direct or occur through changes in glucose metabolism. To clarify the roles of glucose metabolism in this process, we examined the interactions between glucose and PRL on glucose metabolism, insulin secretion, and glucokinase expression in insulin 1 (INS-1) cells and rat islets. Although the PRL-induced changes were more pronounced after culture at higher glucose concentrations, an increase in glucose metabolism, insulin secretion, and glucokinase expression occurred even in the absence of glucose. The presence of comparable levels of insulin secretion at similar rates of glucose metabolism from both control and PRL-treated INS-1 cells suggests the PRL-induced increase in glucose metabolism is responsible for the increase in insulin secretion. Similarly, increases in other known PRL responsive genes (e.g. the PRL receptor, glucose transporter-2, and insulin) were also detected after culture without glucose. We show that the upstream glucokinase promoter contains multiple STAT5 binding sequences with increased binding in response to PRL. Corresponding increases in glucokinase mRNA and protein synthesis were also detected. This suggests the PRL-induced increase in glucokinase mRNA and its translation are sufficient to account for the elevated glucokinase activity in β-cells with lactogens. Importantly, the increase in islet glucokinase observed with PRL is in line with that observed in islets during pregnancy.

Download Full-text

Comparison of Clinical Features between Primary Aldosteronism and Essential Hypertension in Chinese Patients: A Case-Control Study

International Journal of Endocrinology ◽

10.1155/2021/6685469 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Xiaoyu Huang ◽

Shuang Yu ◽

Huangmeng Xiao ◽

Ling Pei ◽

Yan Chen ◽

...

Keyword(s):

Essential Hypertension ◽

Insulin Secretion ◽

Clinical Features ◽

Primary Aldosteronism ◽

Structural Damage ◽

Case Control ◽

Secondary Hypertension ◽

Left Ventricular ◽

Chinese Patients ◽

Significant Difference

Primary aldosteronism (PA) is one of the most common forms of secondary hypertension. Recent studies suggest that, compared with essential hypertension (EH), PA presents more severe disorders of glycolipid metabolism and organ damages. This case-control retrospective study aimed to ascertain clinical features and metabolic parameters between Chinese patients of PA and EH. 174 PA patients and 174 matched EH patients were recruited. Their clinical features, biochemistry parameters, the ventricular septal thickness, and left ventricular mass index (LVMI) were compared. HOMA-β% and HOMA-IR were calculated to evaluate glucose metabolism. The results showed that there was no significant difference regarding BMI, waist-to-hip ratio, and blood pressure between the two groups. The blood potassium level was significantly lower in PA patients than those in EH patients. The abnormal glucose tolerance and the incidence of diabetes in the PA group were not significantly different from those in EH group, but the insulin secretion levels at 0 min and 30 min were significantly weaker than those in the EH group, and the HOMA-β% was also lower in the PA group than those in the EH group. Left ventricular structural abnormalities in PA patients were more severe than those in EH patients. Subtype analysis indicated that patient with aldosterone-producing adenoma (APA) has more serious hypokalemia and lower levels of HOMA-β% and HOMA-IR comparing to those in the idiopathic adrenal hyperplasia (IHA) patient. These findings demonstrated that PA patients showed more impaired insulin secretion function and more severe left ventricular structural damage compared with EH patients.

Download Full-text

Importance of the route of insulin delivery to its control of glucose metabolism

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00628.2020 ◽

2021 ◽

Author(s):

Dale S. Edgerton ◽

Mary Courtney Moore ◽

Justin M. Gregory ◽

Guillaume Kraft ◽

Alan D. Cherrington

Keyword(s):

Insulin Secretion ◽

Glucose Metabolism ◽

Glucose Uptake ◽

Hepatic Glucose Production ◽

Glucose Production ◽

The Body ◽

Whole Body ◽

Direct Effects ◽

Pancreatic Insulin ◽

Hepatic Glucose

Pancreatic insulin secretion produces an insulin gradient at the liver compared to the rest of the body (approximately 3:1). This physiologic distribution is lost when insulin is injected subcutaneously, causing impaired regulation of hepatic glucose production and whole body glucose uptake, as well as arterial hyperinsulinemia. Thus, the hepatoportal insulin gradient is essential to the normal control of glucose metabolism during both fasting and feeding. Insulin can regulate hepatic glucose production and uptake through multiple mechanisms, but its direct effects on the liver are dominant under physiologic conditions. Given the complications associated with iatrogenic hyperinsulinemia in patients treated with insulin, insulin designed to preferentially target the liver may have therapeutic advantages.

Download Full-text

Effects of obesity and ovarian steroids on insulin secretion and removal in sheep

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.1989.256.1.e116 ◽

1989 ◽

Vol 256 (1) ◽

pp. E116-E128 ◽

Cited By ~ 1

Author(s):

J. P. McCann ◽

E. N. Bergman ◽

T. J. Reimers

Keyword(s):

Insulin Secretion ◽

Glucose Metabolism ◽

Plasma Concentrations ◽

Tolerance Test ◽

Intravenous Glucose Tolerance Test ◽

Interactive Effects ◽

Intravenous Glucose ◽

Hepatic Glucose ◽

Organ Removal ◽

Glucose Output

The interactive effects of sex steroids and obesity on glucose metabolism and pancreatic secretion and organ removal of insulin were determined in multicatheterized lean and obese sheep by multiplying venoarterial concentration differences by plasma flows. Ovariectomized lean and dietary obese ewes received implants of progesterone and estradiol-17 beta that produced plasma concentrations of each equivalent to those during either anestrus (low progesterone), diestrus or pregnancy (high progesterone), or estrus (high estradiol). Sheep were exposed to each of the three steroid treatments for 2 days and fasted overnight before blood samples were collected for 5 h before (basal) and 90 min after injecting glucose (200 mg/kg) to simulate an intravenous glucose tolerance test (IVGTT). Regardless of steroid treatment, pancreatic secretory (18 vs. 5 mU/min) and hepatic (10 vs. 2 mU/min) and hindquarters (1.8 vs. 0.5 mU/min) removal rates of insulin in the basal state were greater (P less than 0.005) in obese than lean sheep. Obese sheep had greater (P less than 0.025) basal hepatic glucose output (66 vs. 47 mg/min) and similar hindquarters glucose removal (37 vs. 32 mg/min) as lean sheep even though arterial concentrations of insulin were fourfold higher (25 vs. 6 microU/ml; P less than 0.01) in the obese sheep. High progesterone increased (P less than 0.05) basal hepatic insulin removal in obese sheep. High progesterone and high estradiol increased insulin but decreased (P less than 0.05) glucose removal in hindquarters of obese sheep in the basal state. High progesterone potentiated significantly glucose-induced hyperinsulinemia in obese sheep, whereas high estradiol suppressed hepatic insulin removal but increased the removal of insulin by hindquarters during glucose stimulation in the obese sheep. We concluded that excessive insulin secretion, not decreased insulin removal, maintains the basal hyperinsulinemia in moderately obese sheep and that the progesterone-to-estradiol ratio has marked and divergent effects on insulin and glucose metabolism in individual tissues of sheep both in the basal state and during an IVGTT.

Download Full-text