インスリン産生腫瘍におけるインスリン分泌抑制能について.インスリン低血糖時における血中C-peptide immunoreactivity (CPR) 変動による検討

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タイトル別名
  • Suppressibility of Insulin Secretion in Insulinoma. Plasma C-Peptide Immunoreactivity (CPR) Response to Insulin-Induced Hypoglycemia
  • インスリン サンセイ シュヨウ ニ オケル インスリン ブンピ ヨクセイノウ

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Plasma C-peptide immunoreactivity (CPR) levels during insulin-induced hypoglycemia were measured in a patient with insulinoma and in normal subjects, in order to investigate the change in the suppressibility of endogenous insulin secretion by hypoglycemia in insulinoma.<BR>A 42-year-old man, who had suffered from hypoglycemic symptoms for about 10 years was found to have an islet tumor. His fasting blood sugar levels were 34 to 84 mg/dl, and plasma immunoreactive insulin (IRI) levels were 17 to 37μU/ml before operation. Although after being fasted for 20 hours his blood sugar level fell to 12 mg/dl, plasma IRI and CPR remained to be 23μU/ml and 4.45 pg/ml, respectively. Insulin tolerance test (ITT) is intravenous administration of Mc actrapid insulin® at a shot at the rate of 0.1 U/kg, was performed in the patient before operation and on the 29th day after the surgical resection of a benign adenoma weighing 2.0g; the responses of plasma CPR and blood sugar to the injection were compared with those in 19 normal subjects. In the patient, following the insulin injection, blood sugar level fell to the nadir at 30 minute (26 mg/dl) before the surgery and at 45 minute (50 mg/dl) after the surgery. These blood sugar responses were not so markedly different from the normal. However, the lowest plasma CPR level following the insulin injectin was 71.9% of the initial value before the surgery, which was significantly higher than the corresponding normal value (39.9±11.9%). After the surgery the response of plasma CPR to the insulin injection was restored to the normal, and the lowest CPR after the insulin injection was 32.5% of the initial value. These findings suggest the lack or the diminution of suppressibility of endogenous insulin secretion in insulinoma, and the measurement of CPR in ITT may be of use for the clinical diagnosis of insulinoma.

収録刊行物

  • 糖尿病

    糖尿病 20 (6), 774-782, 1977

    一般社団法人 日本糖尿病学会

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