Increased amino acid clearance and urea synthesis in a patient with glucagonoma.
Open accessAbstract
Fasting concentrations, clearance of exogenous infused amino acids, and lean body mass were studied in a patient with glucagonoma syndrome (fasting glucagon = 380 pmol/l, normal range 15-45 pmol). The fasting concentrations of all amino acids were reduced. The clearances of alanine, arginine, glycine, isoleucine, leucine, lysine, methionine, proline, serine, threonine, and tyrosine were increased. The urea synthesis rate during amino acid infusion was 27 mumols/kg per minute (normal range 20-24 mumols/kg per minute). The lean body mass of the patients was reduced to 59% of the expected value. It is suggested that the weight loss of patients with glucagonoma syndrome is partly due to increased hepatic conversion of amino acid nitrogen to urea nitrogen, resulting in decreased blood amino acid concentration, and secondary to this, organ protein catabolism, as shown by the decreased lean body mass.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Glucagonoma is characterised by very high levels of circulating GCG, low levels of amino-acids, and sarcopenia.
“An extreme example of the effects of GCG on lean mass is in individuals with glucagonoma, which is characterised by very high levels of circulating GCG, low levels of amino-acids, and sarcopenia [61, 62].”
From Triple Agonism Based Therapies for Obesity (2025) · cites this paper as [61]
The Case report records markedly elevated plasma glucagon, and the Results report reduced fasting concentrations of all amino acids and lean body mass at 59% of the expected value in one patient. The paper supports loss of lean mass but does not specifically establish sarcopenia or show that it characterises people with glucagonoma generally. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
A RAPID AND PRECISE METHOD FOR THE DETERMINATION OF UREA
Fawcett, J. K., & Scott, J. E. (1960) · Journal of Clinical Pathology · doi:10.1136/jcp.13.2.156 · Cited by 2,807 · see citing works
Determination of total serum insulin (IRI) in insulin-treated diabetic patients
Hedïng, L. G. (1972) · Diabetologia · doi:10.1007/bf01225569 · Cited by 708 · see citing works
Mallinson, C. N., Bloom, S. R., Warin, A. P., Salmon, P. R., & Cox, B. (1974) · The Lancet · doi:10.1016/s0140-6736(74)91343-9 · Cited by 505 · see citing works
Urinary creatinine excretion and lean body mass
Forbes, G., & Bruining, G. J. (1976) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/29.12.1359 · Cited by 490 · see citing works
Radioimmunological determination of pancreatic and gut glucagon in plasma
Hedïng, L. G. (1971) · Diabetologia · doi:10.1007/bf02346248 · Cited by 394 · see citing works
Effects of Glucagon on Amino Acid Transport and Utilization in the Perfused Rat Liver
Mallette, L. E., Exton, J. H., & Park, C. R. (1969) · Journal of Biological Chemistry · doi:10.1016/s0021-9258(18)63619-1 · Cited by 205 · see citing works
Synthesis of urea after stimulation with amino acids: relation to liver function.
Vilstrup, H. (1980) · Gut · doi:10.1136/gut.21.11.990 · Cited by 137 · see citing works
Self-citationEffects of glucagon on plasma amino acids.
Boden, G., Rezvani, I., & Owen, O. E. (1984) · Journal of Clinical Investigation · doi:10.1172/jci111272 · Cited by 118 · see citing works
Spectrophotometric Quantitation of Plasma and Urinary Amino Nitrogen with Fluorodinitrobenzene
Goodwin, J. F., SCHOENFELD, R. G., & Ryland, M. E. (1970) · Standard methods of clinical chemistry · doi:10.1016/b978-0-12-609106-9.50014-2 · Cited by 101 · see citing works
Lindberg, W., Natvig, H., RYGH, A., & SVENDSEN, K. (1956) · PubMed · Cited by 52 · see citing works
Free amino acid levels in muscle and liver of a patient with glucagonoma syndrome
Roth, E., Mühlbacher, F., Karner, J., Hamilton, G., & Funovics, M. A. (1987) · Metabolism · doi:10.1016/0026-0495(87)90055-2 · Cited by 51 · see citing works
Increased Intestinal Hydrolysis of Urea in Patients with Alcoholic Cirrhosis
Hansen, B. A., & Vilstrup, H. (1985) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365528509091662 · Cited by 51 · see citing works
Self-citationThe effects of glucagon on protein metabolism in normal man.
Wolfe, B. M., Culebras, J. M., Aoki, T. T., O'Connor, N. E., Finley, R. J., Kaczowka, A., & Moore, F. D. (1979) · PubMed · Cited by 49 · see citing works
Increased hepatic amino nitrogen conversion after elective cholecystectomy in man
Heindorff, H., Vilstrup, H., Bucher, D., Billesbølle, P., & Thygesen, V. (1988) · Clinical Science · doi:10.1042/cs0740539 · Cited by 35 · see citing works
Self-citationLoss of Nitrogen from Organs in Rats Induced by Exogenous Glucagon*
Almdal, T., & Vilstrup, H. (1988) · Endocrinology · doi:10.1210/endo-123-5-2182 · Cited by 27 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 2
- Lindberg W, Natvig H, Rygh A, Svendsen K. Weight and height in adult men and women. TidskrNorLaegeforen 1956; 361-8.
- Vilstrup H, Hansen BA, Almdal T, Petersen KF, Sigsgaard, Poulsen HE. The capacity of urea synthesis in rats: regulation and physiological importance. In: Soeters PB. Wilson JHP, Meijer AJ, Holm E, eds. Advances in ammonia metabolism and hepatic encephalopathy. Amsterdam: Excerpta Medica, 1988: 79-85.
Cited by
Sorted by citations
Glucagon receptor knockout prevents insulin-deficient type 1 diabetes in mice
Lee, Y., Wang, M.-Y., Du, X. Q., Charron, M. J., & Unger, R. H. (2011) · Diabetes · doi:10.2337/db10-0426 · Cited by 327 · see citing works
Glucagon Receptor Signaling and Glucagon Resistance
Janah, L., Kjeldsen, S. A. S., Galsgaard, K. D., Winther‐Sørensen, M., Stojanovska, E., Pedersen, J., Knop, F. K., Holst, J. J., & Albrechtsen, N. J. W. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20133314 · Cited by 205 · see citing works
The glucagonoma syndrome and necrolytic migratory erythema: a clinical review
van Beek, A., de Haas, E., van Vloten, W., Lips, C., Roijers, J., & Canninga-van Dijk, M. (2004) · European Journal of Endocrinology · doi:10.1530/eje.0.1510531 · Cited by 202 · see citing works
Glucagon and Amino Acids Are Linked in a Mutual Feedback Cycle: The Liver–α-Cell Axis
Holst, J. J., Wewer Albrechtsen, N. J., Pedersen, J., & Knop, F. K. (2017) · Diabetes · doi:10.2337/db16-0994 · Cited by 187 · see citing works
The Liver–α-Cell Axis and Type 2 Diabetes
Albrechtsen, N. J. W., Pedersen, J., Galsgaard, K. D., Winther‐Sørensen, M., Suppli, M. P., Janah, L., Gromada, J., Vilstrup, H., Knop, F. K., & Holst, J. J. (2019) · Endocrine Reviews · doi:10.1210/er.2018-00251 · Cited by 149 · see citing works
Self-citationWinther-Sørensen, M., Galsgaard, K. D., Santos, A., Trammell, S. A. J., Sulek, K., Kuhre, R. E., Pedersen, J., Andersen, D. B., Hassing, A. S., Dall, M., et al. (2020) · Molecular Metabolism · doi:10.1016/j.molmet.2020.101080 · Cited by 135 · see citing works
Self-citationWewer Albrechtsen, N. J., Færch, K., Jensen, T. M., Witte, D. R., Pedersen, J., Mahendran, Y., Jonsson, A. E., Galsgaard, K. D., Winther-Sørensen, M., Torekov, S. S., et al. (2018) · Diabetologia · doi:10.1007/s00125-017-4535-5 · Cited by 119 · see citing works
Protein- and diabetes-induced glomerular hyperfiltration: role of glucagon, vasopressin, and urea
Bankir, L., Roussel, R., & Bouby, N. (2015) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.00614.2014 · Cited by 111 · see citing works
Albrechtsen, N. J. W., Junker, A. E., Christensen, M., Hædersdal, S., Wibrand, F., Lund, A. M., Galsgaard, K. D., Holst, J. J., Knop, F. K., & Vilsbøll, T. (2017) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00216.2017 · Cited by 98 · see citing works
The Liver–α-Cell Axis in Health and in Disease
Richter, M. M., Galsgaard, K. D., Elmelund, E., Knop, F. K., Suppli, M. P., Holst, J. J., Winther‐Sørensen, M., Kjeldsen, S. A. S., & Albrechtsen, N. J. W. (2022) · Diabetes · doi:10.2337/dbi22-0004 · Cited by 87 · see citing works
Alexander, E. K., Robinson, M., Staniec, M., & Dluhy, R. G. (2002) · Clinical Endocrinology · doi:10.1046/j.1365-2265.2002.01660.x · Cited by 87 · see citing works
Oxyntomodulin: actions and role in diabetes
Holst, J. J., Albrechtsen, N. J. W., Gabe, M. B. N., & Rosenkilde, M. M. (2018) · Peptides · doi:10.1016/j.peptides.2017.09.018 · Cited by 86 · see citing works
Outerbridge, C. A., Marks, S. L., & Rogers, Q. R. (2002) · Veterinary Dermatology · doi:10.1046/j.1365-3164.2002.00295.x · Cited by 84 · see citing works
Glucagon’s effect on liver protein metabolism in vivo
Kraft, G., Coate, K. C., Winnick, J. J., Dardevet, D. P., Donahue, E. P., Cherrington, A. D., Williams, P. E., & Moore, M. C. (2017) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00045.2017 · Cited by 40 · see citing works
Glucagon revisited: Coordinated actions on the liver and kidney
Bankir, L., Bouby, N., Speth, R. C., Velho, G., & Crambert, G. (2018) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2018.10.004 · Cited by 40 · see citing works
Glucose and amino acid metabolism in mice depend mutually on glucagon and insulin receptor signaling
Galsgaard, K. D., Winther‐Sørensen, M., Pedersen, J., Kjeldsen, S. A. S., ROSENKILDE, M. M., Albrechtsen, N. J. W., & Holst, J. J. (2019) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00410.2018 · Cited by 35 · see citing works
Glucagon receptor signaling in metabolic diseases
Albrechtsen, N. J. W. (2018) · Peptides · doi:10.1016/j.peptides.2017.11.016 · Cited by 27 · see citing works
Grøfte, T., Jensen, D. S., Grønbæk, H., Wolthers, T., Jensen, S. A., Tygstrup, N., & Vilstrup, H. (1998) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1998.275.1.e79 · Cited by 28 · see citing works
Self-citationGlucagon resistance and metabolic-associated steatotic liver disease: a review of the evidence
McGlone, E. R., Bloom, S. R., & Tan, T. (2024) · Journal of Endocrinology · doi:10.1530/joe-23-0365 · Cited by 26 · see citing works
Triple Agonism Based Therapies for Obesity
Goldney, J., Hamza, M., Surti, F., Davies, M. J., & Papamargaritis, D. (2025) · Current Cardiovascular Risk Reports · doi:10.1007/s12170-025-00770-z · Cited by 22 · see citing works
Characterization of aminoaciduria and hypoaminoacidemia in dogs with hepatocutaneous syndrome
Loftus, J. P., Lucy, J. M., Stanton, J. A., McDonough, S. P., Peters‐Kennedy, J., Arceneaux, K. P., Bechtold, M. A., Bennett, C. L., Bradbury, C. A., Cline, M. G., et al. (2017) · American Journal of Veterinary Research · doi:10.2460/ajvr.78.6.735 · Cited by 22 · see citing works
Li, W., Kirchner, T., Ho, G., Bonilla, F., D'Aquino, K., Littrell, J., Zhang, R., Jian, W., Qiu, X., Zheng, S., et al. (2020) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.14173 · Cited by 20 · see citing works
Adeva‐Andany, M. M., Fernández‐Fernández, C., López-Pereiro, Y., Calvo‐Castro, I., & Carneiro-Freire, N. (2021) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2021.06.025 · Cited by 19 · see citing works
Clinical and biochemical footprints of inherited metabolic diseases. VI. Metabolic dermatoses
Ferreira, C. R., Martinelli, D., & Blau, N. (2021) · Molecular Genetics and Metabolism · doi:10.1016/j.ymgme.2021.07.005 · Cited by 19 · see citing works
Hope, D. C. D., & Tan, T. M.-M. (2023) · Peptides · doi:10.1016/j.peptides.2023.170962 · Cited by 16 · see citing works
Atlas of Dermatology in Internal Medicine
Sánchez, N. P. (2011) · Springer eBooks · doi:10.1007/978-1-4614-0688-4 · Cited by 16 · see citing works
Islet hormones at the intersection of glucose and amino acid metabolism
White, P. J., Albrechtsen, N. J. W., & Campbell, J. E. (2025) · Nature Reviews Endocrinology · doi:10.1038/s41574-025-01100-4 · Cited by 14 · see citing works
Loftus, J. P., Astor, M. T., Miller, A. J., & Peters-Kennedy, J. (2021) · Journal of Veterinary Internal Medicine · doi:10.1111/jvim.16259 · Cited by 13 · see citing works
Nuttall, F. Q., & Gannon, M. C. (2012) · Nutrition & Metabolism · doi:10.1186/1743-7075-9-43 · Cited by 11 · see citing works
Ruocco, C., Malavazos, A., Ragni, M., Carruba, M., Valerio, A., Iacobellis, G., & Nisoli, E. (2023) · Pharmacological Research · doi:10.1016/j.phrs.2023.106892 · Cited by 9 · see citing works
Grøfte, T., Wolthers, T., Jørgensen, J. O. L., Poulsen, P. L., Vilstrup, H., & Møller, N. (1999) · Journal of Hepatology · doi:10.1016/s0168-8278(99)80134-2 · Cited by 10 · see citing works
Self-citationHepatic CBP/p300 Orchestrate Amino Acid‐Driven Gluconeogenesis through Histone Crotonylation
Sheng, C., Li, T., Lin, H., Ma, X., Zhou, F., Li, M., Wang, Y., Wang, S., Tan, J., Chen, J. Y., et al. (2025) · Advanced Science · doi:10.1002/advs.202507635 · Cited by 7 · see citing works
Kjeldsen, S. A. S., Werge, M. P., Grandt, J., Richter, M. M., Thing, M., Hetland, L. E., Rashu, E. B., Jensen, A. H., Winther‐Sørensen, M., Kellemann, J. S., et al. (2024) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00147.2024 · Cited by 6 · see citing works
Holm, S. M., Peng, S. A., Holter, M. M., Cummings, B. P., & Loftus, J. P. (2022) · American Journal of Veterinary Research · doi:10.2460/ajvr.22.10.0174 · Cited by 6 · see citing works
Hyperglucagonemia and the immediate fate of dietary leucine: A kinetic study in humans
Marchini, J. S., Marks, L. M., Darmaun, D., Young, V. R., & Krempf, M. (1998) · Metabolism · doi:10.1016/s0026-0495(98)90230-x · Cited by 6 · see citing works
Rare Neuroendocrine Tumors of the Pancreas
Cheng, S., & Doherty, G. M. (2009) · Cancer treatment and research · doi:10.1007/978-1-4419-0857-5_14 · Cited by 4 · see citing works
Nutritional Management of Skin Diseases
Outerbridge, C. A., & Owens, T. J. (2023) · doi:10.1002/9781119375241.ch14 · Cited by 4 · see citing works
Aminoaciduric Canine Hypoaminoacidemic Hepatopathy Syndrome
Loftus, J. P. (2025) · Veterinary Clinics of North America Small Animal Practice · doi:10.1016/j.cvsm.2025.03.009 · Cited by 3 · see citing works
Galsgaard, K. D., Jepsen, S. L., Kjeldsen, S. A. S., Pedersen, J., Albrechtsen, N. J. W., & Holst, J. J. (2019) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/792119 · Cited by 3 · see citing works
Pisegna, J. R. (2012) · Molecular pathology library · doi:10.1007/978-1-4614-6015-2_12 · Cited by 2 · see citing works
Sarfraz, M., Ullah, H., Iqbal, R., Shaheen, G., Albalawi, M. A., Alatawi, F. S., Omran, A., Areefy, A. A. A., Abdulsalam, N. M., Khateeb, N. A., et al. (2023) · Journal of Animal and Feed Sciences · doi:10.22358/jafs/168793/2023 · Cited by 1 · see citing works
Glucagon infusion alters the circulating metabolome and urine amino acid excretion in dogs
Merkhassine, M., Coch, R. W., Frederick, C. E., Bennett, L. L., Peng, S. A., Morse, B., Cummings, B. P., & Loftus, J. P. (2024) · Journal of Endocrinology · doi:10.1530/joe-24-0051 · Cited by 1 · see citing works
Nutritional Management of Skin Diseases
Outerbridge, C. A. (2012) · doi:10.1002/9781118785669.ch11 · Cited by 1 · see citing works
Pancreatic Neuroendocrine Tumors
Sakr, M. F. (2016) · Springer eBooks · doi:10.1007/978-3-319-27532-1_14
Cutaneous Manifestations of Internal Malignancy and Paraneoplastic Syndromes
Fuxench, Z. C. C., Ramírez, L., & Sánchez, N. P. (2011) · Springer eBooks · doi:10.1007/978-1-4614-0688-4_6
Albinus, M., Amschler, G., Amschler, U., Angerer, E. V., Barthel, W., Bauer, A., Bauer, K., Beckmann, J., Beil, W., Beitz, J., et al. (1994) · Springer eBooks · doi:10.1007/978-3-642-57880-9_4
Albinus, M., Amschler, G., Amschler, U., Angerer, E. V., Barthel, W., Bauer, A., Bauer, K., Beckmann, J., Beil, W., Beitz, J., et al. (1994) · Springer eBooks · doi:10.1007/978-3-642-57880-9_5
Winther‐Sørensen, M., Rasmussen, C. B., Trammell, S. A. J., Hansen, C., Vyberg, M., Serizawa, R., Richter, E. A., Grevengoed, T. J., Gluud, L. L., Kuhre, R. E., et al. (2025) · Peptides · doi:10.1016/j.peptides.2025.171462
Regulators of appetite in mammals—old and new players
Fernandes, J. H., Silva, J. D., Costa, M. D., & Maciel, P. (2026) · Endocrine Reviews · doi:10.1210/endrev/bnag020
- Authors
- Almdal, T. P., Heindorff, H., Bardram, L., & Vilstrup, H.
- Affiliations
- Rigshospitalet (DK)
- Venue
- Gut
- Publisher
- BMJ
- Published
- 1990-08
- Volume
- 31
- Issue
- 8
- Pages
- 946-948
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1378630
- OpenAlex
- W2024131582
- Semantic Scholar
- c78c0dedd62359e7760a105abaef9b8b3b6856b7
- Cited by
- 49
- References
- 15
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 3 · 2023: 4 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 4 · 2018: 4 · 2017: 4 · 2016: 1 · 2015: 1 · 2012: 3
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Keywords
- glucagonoma, glucagonoma syndrome, amino acid clearance, urea synthesis, weight loss, lean body mass, protein degradation, amino acid infusion
- MeSH terms
- Amino Acids, Female, Glucagonoma, Humans, Adenoma, Islet Cell, Middle Aged, Pancreatic Neoplasms, Urea
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
