Portal and peripheral vein concentrations of insulin and glucagon after arginine infusion in morbidly obese subjects
Abstract
Five morbidity obese subjects with fasting normoglycemia underwent catheterization of portal and peripheral veins immediately prior to jejunoileal bypass surgery. Levels of immunoreactive insulin (IRI), immunoreactive glucagon (IRG), and glucose were determined in simultaneously obtained serum samples before and after infusion of arginine. Portal levels exceeded peripheral levels by at least 50% with IRI and by 30%-40% with IRG. These results were similar to those reported in nonobese subjects and show that in morbid obesity as well as in nonobese states, peripheral insulin to glucagon molar ratios (I/G) underestimate portal I/G. Although hepatic extraction was not specifically measured, the data suggest that the peripheral levels of insulin and glucagon reported in morbid obesity result from alterations in secretion and not altered extraction.
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Because the normal hepatic portal-to-peripheral venous insulin concentration ratio is ~2.5:1.0, the mild peripheral hyperinsulinemia during somatostatin with insulin likely produced portal hypoinsulinemia.
“Since the normal hepatic portal-to-peripheral venous insulin concentration ratio is ~2.5:1.0 (29–32), this mild peripheral hyper-nsn n s s sn ns linemia.”
From Epinephrine supports the postabsorptive plasma glucose concentration and prevents hypoglycemia when glucagon secretion is deficient in man (1984) · cites this paper as [31]
The hepatic portal venous to peripheral venous insulin ratio is normally approximately 2.5:1.
“since the hepatic portal venous to peripheral venous insulin ratio is normally ~2.5:1 (14-16)”
The portal venous to peripheral venous plasma glucagon ratio is approximately 1.5:1 in humans.
“The portal venous to peripheral venous plasma glucagon ratio is ~1.5:1 in humans (14-16)”
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References 27 · Cited by 22
- Authors
- Walter, R. M., Gold, E. M., Michas, C. A., & Ensinck, J. W.
- Affiliations
- University of California Davis Medical Center (US)
- Corresponding author
- Walter, Robert M.
- Venue
- Metabolism
- Publisher
- Elsevier BV
- Published
- 1980-11
- Volume
- 29
- Issue
- 11
- Pages
- 1037-1040
- ISSN
- 0026-0495 (ISSN-L)
- OpenAlex
- W1973971195
- Cited by
- 22
- References
- 27
- Citations by year
- 2026: 2 · 2024: 1 · 2021: 1 · 2020: 1
- FWCI
- 2.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- morbid obesity, insulin, glucagon, portal vein, peripheral veins, arginine infusion, jejunoileal bypass, insulin/glucagon ratio, hepatic extraction, hepatic secretion, glucose
- MeSH terms
- Adult, Arginine, Elbow, Female, Glucagon, Humans, Insulin, Obesity, Portal Vein, Veins
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