Skip to main content
PMC home page
The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1992 Jun;89(6):1761–1766. doi: 10.1172/JCI115779

Effects of hemipancreatectomy on pancreatic alpha and beta cell function in healthy human donors.

E R Seaquist 1, R P Robertson 1
PMCID: PMC295869  PMID: 1601986

Abstract

To assess the metabolic consequences of hemipancreatectomy in humans, we determined pancreatic beta and alpha cell function in healthy donors. Donors examined cross-sectionally were found to have significantly decreased glucose-induced phasic insulin secretion and arginine-induced insulin and glucagon secretion as compared to age, sex, and body index-matched controls. However, their fasting glucose and insulin values were not different from controls. Similar observations were found in the prospective evaluation of eight donors before and 15 +/- 2 mo after hemipancreatectomy. Beta cell reserve, as measured by glucose potentiation of arginine-induced insulin secretion, was significantly decreased in donors (maximal acute insulin response [AIRmax]: donors = 666 +/- 84 pM vs controls = 1,772 +/- 234 pM) while the PG50 (the glucose value at which the half-maximal response was observed) was the same in the two groups. Donors and controls responded to 60-min continuous intravenous infusions of glucose by reaching identical serum glucose values, despite significantly lower insulin secretory responses in donors. We conclude that hemipancreatectomy in human donors is associated with decreased pancreatic alpha and beta cell function. Since donors generally maintain normoglycemia after hemipancreatectomy despite diminished insulin secretion, our data suggest that healthy humans may compensate for hemipancreatectomy by increasing glucose disposal.

Full text

PDF
1761

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baron A. D., Kolterman O. G., Bell J., Mandarino L. J., Olefsky J. M. Rates of noninsulin-mediated glucose uptake are elevated in type II diabetic subjects. J Clin Invest. 1985 Nov;76(5):1782–1788. doi: 10.1172/JCI112169. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Blondel O., Bailbe D., Portha B. Insulin resistance in rats with non-insulin-dependent diabetes induced by neonatal (5 days) streptozotocin: evidence for reversal following phlorizin treatment. Metabolism. 1990 Aug;39(8):787–793. doi: 10.1016/0026-0495(90)90120-2. [DOI] [PubMed] [Google Scholar]
  3. Bolinder J., Gunnarsson R., Tydén G., Brattström C., Ostman J., Groth C. G. Metabolic effects of living related pancreatic graft donation. Transplant Proc. 1988 Jun;20(3):475–478. [PubMed] [Google Scholar]
  4. Bonner-Weir S., Trent D. F., Weir G. C. Partial pancreatectomy in the rat and subsequent defect in glucose-induced insulin release. J Clin Invest. 1983 Jun;71(6):1544–1553. doi: 10.1172/JCI110910. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Chen L., Alam T., Johnson J. H., Hughes S., Newgard C. B., Unger R. H. Regulation of beta-cell glucose transporter gene expression. Proc Natl Acad Sci U S A. 1990 Jun;87(11):4088–4092. doi: 10.1073/pnas.87.11.4088. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Gersell D. J., Gingerich R. L., Greider M. H. Regional distribution and concentration of pancreatic polypeptide in the human and canine pancreas. Diabetes. 1979 Jan;28(1):11–15. [PubMed] [Google Scholar]
  7. Gotoh M., Monden M., Okamura J., Mori T., Shima K. Insulin and glucagon secretion after pancreatectomies. Correlation of secretion and hormonal contents of remaining pancreas. Diabetes. 1989 Jul;38(7):861–867. doi: 10.2337/diab.38.7.861. [DOI] [PubMed] [Google Scholar]
  8. Halter J. B., Graf R. J., Porte D., Jr Potentiation of insulin secretory responses by plasma glucose levels in man: evidence that hyperglycemia in diabetes compensates for imparied glucose potentiation. J Clin Endocrinol Metab. 1979 Jun;48(6):946–954. doi: 10.1210/jcem-48-6-946. [DOI] [PubMed] [Google Scholar]
  9. Hansen I. L., Cryer P. E., Rizza R. A. Comparison of insulin-mediated and glucose-mediated glucose disposal in patients with insulin-dependent diabetes mellitus and in nondiabetic subjects. Diabetes. 1985 Aug;34(8):751–755. doi: 10.2337/diab.34.8.751. [DOI] [PubMed] [Google Scholar]
  10. Imamura T., Koffler M., Helderman J. H., Prince D., Thirlby R., Inman L., Unger R. H. Severe diabetes induced in subtotally depancreatized dogs by sustained hyperglycemia. Diabetes. 1988 May;37(5):600–609. doi: 10.2337/diab.37.5.600. [DOI] [PubMed] [Google Scholar]
  11. Kahn B. B., Shulman G. I., DeFronzo R. A., Cushman S. W., Rossetti L. Normalization of blood glucose in diabetic rats with phlorizin treatment reverses insulin-resistant glucose transport in adipose cells without restoring glucose transporter gene expression. J Clin Invest. 1991 Feb;87(2):561–570. doi: 10.1172/JCI115031. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Kendall D. M., Sutherland D. E., Najarian J. S., Goetz F. C., Robertson R. P. Effects of hemipancreatectomy on insulin secretion and glucose tolerance in healthy humans. N Engl J Med. 1990 Mar 29;322(13):898–903. doi: 10.1056/NEJM199003293221305. [DOI] [PubMed] [Google Scholar]
  13. Leahy J. L., Bonner-Weir S., Weir G. C. Abnormal glucose regulation of insulin secretion in models of reduced B-cell mass. Diabetes. 1984 Jul;33(7):667–673. doi: 10.2337/diab.33.7.667. [DOI] [PubMed] [Google Scholar]
  14. Leahy J. L., Bonner-Weir S., Weir G. C. Minimal chronic hyperglycemia is a critical determinant of impaired insulin secretion after an incomplete pancreatectomy. J Clin Invest. 1988 May;81(5):1407–1414. doi: 10.1172/JCI113470. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. McGuire E. A., Helderman J. H., Tobin J. D., Andres R., Berman M. Effects of arterial versus venous sampling on analysis of glucose kinetics in man. J Appl Physiol. 1976 Oct;41(4):565–573. doi: 10.1152/jappl.1976.41.4.565. [DOI] [PubMed] [Google Scholar]
  16. Robertson R. P. Type II diabetes, glucose "non-sense," and islet desensitization. Diabetes. 1989 Dec;38(12):1501–1505. doi: 10.2337/diab.38.12.1501. [DOI] [PubMed] [Google Scholar]
  17. Rossetti L., Giaccari A., DeFronzo R. A. Glucose toxicity. Diabetes Care. 1990 Jun;13(6):610–630. doi: 10.2337/diacare.13.6.610. [DOI] [PubMed] [Google Scholar]
  18. Rossetti L., Shulman G. I., Zawalich W., DeFronzo R. A. Effect of chronic hyperglycemia on in vivo insulin secretion in partially pancreatectomized rats. J Clin Invest. 1987 Oct;80(4):1037–1044. doi: 10.1172/JCI113157. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Rossetti L., Smith D., Shulman G. I., Papachristou D., DeFronzo R. A. Correction of hyperglycemia with phlorizin normalizes tissue sensitivity to insulin in diabetic rats. J Clin Invest. 1987 May;79(5):1510–1515. doi: 10.1172/JCI112981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Unger R. H., Grundy S. Hyperglycaemia as an inducer as well as a consequence of impaired islet cell function and insulin resistance: implications for the management of diabetes. Diabetologia. 1985 Mar;28(3):119–121. doi: 10.1007/BF00273856. [DOI] [PubMed] [Google Scholar]
  21. Ward W. K., Bolgiano D. C., McKnight B., Halter J. B., Porte D., Jr Diminished B cell secretory capacity in patients with noninsulin-dependent diabetes mellitus. J Clin Invest. 1984 Oct;74(4):1318–1328. doi: 10.1172/JCI111542. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Ward W. K., Halter J. B., Beard J. C., Porte D., Jr Adaptation of B and A cell function during prolonged glucose infusion in human subjects. Am J Physiol. 1984 May;246(5 Pt 1):E405–E411. doi: 10.1152/ajpendo.1984.246.5.E405. [DOI] [PubMed] [Google Scholar]
  23. Ward W. K., Wallum B. J., Beard J. C., Taborsky G. J., Jr, Porte D., Jr Reduction of glycemic potentiation. Sensitive indicator of beta-cell loss in partially pancreatectomized dogs. Diabetes. 1988 Jun;37(6):723–729. doi: 10.2337/diab.37.6.723. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation

RESOURCES