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ÓÓ:200233,1mgC,,;;;C;TheclinicalapplicationoftheintravenousglucagonstimulatorytestWUSong2hua,MAXiao2jing.ShanghaiDiabetesInstitute,DepartmentofEndocrinologyandMetabolism,ShanghaiJiaotongUniversityAffiliatedNo.6PeoplesHospital,Shanghai200233SummaryTheresearchonmethodologythatassessesislet2cellfunctionisnecessaryforthestudyoftheoccurrence,developmentandtherapyofdiabetesmellitus.Intravenousbolusinjectionof1mgglucagonhasbeenwidelyusedtoassessendogenousinsulinsecretagogueforclinicalorresearchpurposes.KeywordsGlucagon;Isletcellfunction;Diabetesmellitus;C2peptide;Insulin(ChinJEndocrinolMetab,2004,20:4782480)2060Samols(Glg)(INS)1977Faber[1](DM),,,Glg1.Glg:Glg29[2],10min,1mgDMGlgGlg,GlgGlg,,,,,INSGlg,GlgINS,,1030min[3]2.DMGlg:()(INS)GlgGlg[4],Glg8.3mmol/L2.8mmol/LINSGlg[5],INS,INS,GlgINSINSGlg[6],()()[7]GlgINS,,GlgDMDMGlg[8]DMGlg1DMGlgINS,Glg515,Glg2DMGlg,(FFA),FFA,,GlgGlg1.INS:INS(),30minINSINS(INSAIR)INS[9]AIR,INS,,,INS,INS2DM,AIR,INS,INSINSINS,,2.Glg:[1]1mgGlg,06minC()INSINSSnorgaard[10]1mgGlgINS,874200410205ChinJEndocrinolMetab,October2004,Vol20,No.5,(IVGTT),(OGTT)GlgINS,3.520.0mmol/L,DMCINSDMCINSINS,INSINSC,,INS10,Glg,CINSINS,CINSGlgC2DM1DM6min10min,2DM6minCCCGlg6minC,C30minGlgC[11]6min1mgGlg1mgGlg,1530456090120minINSC,Castitlo[11],1mg/m2Glg,Biostator20minINS30min,INSINS(020min,2050min),INS,IVGTT,,Biostator,,3.Glg1(GLP21):GLP21()LGlgINS,,INS,INS[12],INSGlg,GLP21INS,,Glg[13]GLP21,INS,,GLP212.5nmol/L2DM,GLP214.:Glg2:IVGTT10minGlg,Glg(1DM)INS,DM,DMGlg2:GlgINS,11.5h,GlgC,2DMGlg2:GlgINS,,,,Glg1.DM:1DMINS,Glg,2DMGlgDM,1DM,,1DM,INS1DM,2DMINS[14],GlgGlgINSC6min0.6nmol/L,INS,0.6nmol/LINS,INS[15]2DMGlgINS,,Glg,,,[16]Glg2.:INS1mgGlgINS,,GlgINSGlg,,Glg[17]IVGTTOGTT[18221]Glg(),INS,,IVGTTOGTT,,DMINS,974200410205ChinJEndocrinolMetab,October2004,Vol20,No.5INS2DM,2DMINSGlg,,DMGlgDMGlg,DM,DM:(1)(2)()(3)INS,2DM,INS(4),(5)GlgGlg(NovoNordisk,),,2DM,()[22],INS,Glg,2DM,[23,24],1FaberOK,BinderC.C2peptideresponsetoglucagon.Atestfortheresidualbeta2cellfunctionindiabetesmellitus.Diabetes,1977,26:6052610.2BargS.Mechanismsofexocytosisininsulin2secretingB2cellsandglucagon2secretingA2cells.PharmacolToxicol,2003,92:3213.3CryerPE,DavisSN,ShamoonH.Hypoglycemiaindiabetes.DiabetesCare,2003,26:190221912.4JiangG,ZhangBB.Glucagonandregulationofglucosemetabolism.AmJPhysiolEndocrinolMetab,2003,284:E6712678.5AhernB,TaborskyGJJr,HavelPJ.Differentialimpairmentofglucagonresponsestohypoglycemia,neuroglycopenia,arginine,andcarbacholinalloxan2diabeticmice.Metabolism,2002,51:12219.6NesherR,AntebyE,YedovizkyM,etal.Beta2cellproteinkinasesandthedynamicsoftheinsulinresponsetoglucose.Diabetes,2002,51(Suppl1):S682S73.7OskarssonPR,LinsPE,AhreB,etal.Circulatinginsulininhibitsglucagonsecretioninducedbyarginineintype1diabetes.EurJEndocrinol,2000,142:30234.8LarssonH,AhernB.Isletdysfunctionininsulinresistanceinvolvesimpairedinsulinsecretionandincreasedglucagonsecretioninpostmenopausalwomenwithimpairedglucosetolerance.DiabetesCare,2000,23:6502657.9DelPratoS.Lossofearlyinsulinsecretionleadstopostprandialhyperglycaemia.Diabetologia,2003,46(Suppl1):M22M8.10SnorgaardO,HasselstromK,LumholtzIB,etal.Insulin/C2peptideresponsetointravenousglucagon.Adose2responsestudyinnormalandnon2insulin2dependentdiabeticsubjects.ActaEndocrinol,1988,117:1092115.11CastilloMJ,ScheenAJ,LefebvrePJ.Modifiedglucagontestallowingstimultaneousestimationofinsulinsecretionandinsulinsensitivity:applicationtoobesity,insulin2dependentdiabetesmellitus,andnoninsulin2dependentdiabetesmellitus.JClinEndocrinolMetab,1995,80:3932399.12NielsenJH,GalsgaardED,MoldrupA,etal.Regulationofbeta2cellmassbyhormonesandgrowthfactors.Diabetes,2001,50(Suppl1):S252S29.13VilsbollT,Toft2NielsenMB,KrarupT,etal.Evaluationofbeta2cellsecretorycapacityusingglucagon2likepeptide1.DiabetesCare,2000,23:8072812.14WallaceTM,MatthewsDR.Coffcientoffailure:amethodologyforexamininglongitudinalbeta2cellfunctionintype2diabetes.DiabetesMed,2002,19:4652469.15ScheenAJ,CastilloMJ,LefebvrePJ.Glucagon2inducedplasmaC2peptideresponseindiabeticpatients.Influenceofbodyweightandrelationshiptoinsulinrequirement.DiabetesMetab,1996,22:4552458.16BanerjiMA.Impairedbeta2cellandalpha2cellfunctioninAfrican2Americanchildrenwithtype2diabetesmellitusFlatbushdiabetes.JPediatrEndocrinolMetab,2002,15(Suppl1):4932501.17AbsR.UpdateonthediagnosisofGHdeficiencyinadults.EurJEndocrinol,2003,148:S32S8.18..,1999,15:1292130.19,,,..,2001,17:2682271.20,BennettPH.OGTT468Pima.,2003,19:8212.21,..,2003,19:4232424.22Mauvais2JarvisF,AndreelliF,Hanaire2BroutinH,etal.Therapeuticperspectivesfortype2diabetesmellitus:molecularandclinicalinsights.DiabetesMetab,2001,27:4152423.23..,2003,19:124.24.,.,2003,19:527.(:2003210221)084200410205ChinJEndocrinolMetab,October2004,Vol20,No.5