Search PubMed⌕ Search

Biomedical subjects

D Porte

Publications and source records attributed to D Porte.

At least 163 records · Page 9Linked to original sources

Potentiation of insulin secretion to nonglucose stimuli in normal man by tolbutamide.

To determine how sulfonylureas affect beta cell function, insulin release in response to isoproterenol and arginine was assessed in 32 normal subjects before and during a tolbutamide infusion. When the plasma glucose was allowed to decrease during tolbutamide, the acute insulin response (AIR) to isoproterenol was not changed (delta AIR = 4 +/- 8 MicroU/ml, mean +/- SEM, n = 8,p = NS) and was enhanced slightly for arginine (delta AIR = +61 +/- 26 microU/ml, n = 6, p less than 0.05). When plasma glucose levels were maintained by means of a concomitant variable glucose infusion during tolbutamide, the insulin responses to both isoproterenol and arginine were enhanced (isoproterenol: delta AIR = +55 +/- 15 microU/ml, n = 6, p less than 0.001; arginine: delta AIR = +137 +/- 34 microU/ml, n = 8, p less than 0.001). Regression analysis demonstrated a linear relationship between change in the prestimulus glucose level and the change in the AIR to isoproterenol during tolbutamide (r = 0.66, n = 14, p less than 0.02). Since the slope of his relationship is not significantly different from a similar relationship in the absence of tolbutamide, the potentiating effect of tolbutamide is an amplification of an established physiologic relationship. We conclude that tolbutamide augments the insulin response to nonglucose stimuli. However, this potentiating effect of tolbutamide may be masked by a decrease in the prestimulus glucose level.

Arginine↗

Abnormal lipoprotein-lipase-mediated plasma triglyceride removal in untreated diabetes mellitus associated with hypertriglyceridemia.

Hypertriglyceridemia is common in untreated diabetes mellitus. An abnormality in the interaction of lipoprotein lipase with endogenous circulating plasma lipoprotein triglyceride has been demonstrated in untreated diabetes. These diabetics have a decreased maximal removal capacity for plasma triglyceride (27.0 mg TG/kh/hr) and increased Km (390 mg/dl) for endogenous plasma triglyceride-lipoprotein lipase interaction compared to that found in nondiabetic hypertriglyceridemic subjects (Vmax, 32.0; km, 157). Diabetics treated for at least two months have a maximal removal capacity and Km similar to that of nondiabetic subjects (Vmax, 32.7; Km, 192). No evidence for an increase in triglyceride production due to diabetes per se was found. When diabetic subjects with triglyceride levels over 400 mg/dl were selected for study, most were found to have an independent familial form of hypertriglyceridemia.

Adolescent↗

A dual-purpose device for protecting brain implants of baboons.

A device is described which is relatively easy to construct and which can be used to protect brain implants affixed to the skull of large primates. The device is essentially a stainless steel ring cemented around the brain implant. A plexiglass dome can then be attached to the ring to protect the implant. Further, a second device can be constructed which attaches to the ring and which provides gentle leverage to the brain implant to remove adhered obturators.

Animals↗

Differential effects of somatostatin analogues on alpha- and beta-cells of the pancreas.

We examined the effect of somatostatin (SS) and its analogues on basal insulin and glucagon output from the right lobe of the in situ canine pancreas. Somatostatin (0.17 and 1.7 microgram/min, iv) significantly inhibited insulin (delta = -48 +/- 9% and delta = -88 +/- 3%) and glucagon (delta = -13 +/- 16%, P = NS and delta = -55 +/- 8%). Des-Asn5-SS Significantly inhibited insulin (delta = -40 +/- 9% and delta = -92 +/- 3%) but not glucagon (delta = +35 +/- 18% and delta = +4 +/- 12%). Likewise, [D-Ser13]-SS significantly inhibited insulin (delta = -40 +/- 14% and delta = -71 +/- 8%) with only slight inhibition of glucagon (delta = +26 +/- 15%, P = NS and delta = -16 +/- 6%, P less than 0.05). In contrast, [D-Cys14]-SS significantly inhibited both inhibited both insulin and glucagon. We conclude that structural changes of cyclic somatostatin can dissociate its ability to inhibit pancreatic insulin and glucagon secretion. Because the putative receptors on the pancreatic alpha- and beta-cell appear to recognize different configurations of the somatostatin molecule, it is suggested that the receptors themselves are different.

Animals↗

Glucose-induced insulin release during acute and chronic hypoxia.

Glucose-induced insulin release was studied in young dogs during acute and chronic hypoxia, alone and in combination. Six experimental animals were rendered chronically hypoxic (PaO2, 43.4 +/- 0.5 torr) by creation of a right-to-left shunt at age 6-8 wk. Six control animals underwent sham procedures (PaO2, 85 +/- 2.2 torr) at the same age. During air breathing, glucose-induced plasma insulin increases were similar in chronically hypoxic and control animals. When severe hypoxia was acutely produced by ventilation with low-oxygen mixtures in experimental (PaO2, 23.7 +/- 1.7 torr) and control animals (PaO2, 26.3 +/- 1.0 torr), plasma insulin responses were markedly inhibited in both. On the other hand, acutely lowering oxygen tensions of control animals (PaO2, 37.5 +/- 1.4 torr) to levels close to those of air-breathing chronically hypoxic animals did not affect the insulin responses. These observations suggest that glucose-induced insulin release is inhibited by acute severe hypoxia despite previous chronic oxygen deficiency. In contrast, moderate hypoxia, acute or chronic, does not appear to affect the insulin response to a glucose load.

Animals↗

Hyperglucagonemia and alpha-adrenergic receptor in acute hypoxia.

The plasma immunoreactive glucagon (IRG) response to hypoxia was studied in puppies. Three groups of paired experiments were performed. In group I, 8% O2:92% N2 ventilation (PaO2 20--30 torr) produced a rise in plasma IRG and glucose as well as hypotension and bradycardia. However, when group I was air ventilated (PaO2 greater than 70 torr) and given glucose infusions producing hyperglycemia of similar degree, plasma IRG was unchanged. Group II received alpha-adrenergic blockade (phenoxybenzamine). When made hypoxic, group II developed no significant IRG rise and less hyperglycemia than with hypoxia alone. Hypotension was more severe with hypoxia plus alpha-blockade. Phenoxybenzamine itself did not change plasma IRG or glucose during air breathing. Group III receivi developed hyperglucagonemia and hyperglycemia not significantly different from that with hypoxia alone. However, hypoxia-caused hypotension and bradycardia was more pronounced with beta-blockade. No change in plasma IRG or glucose occurred in group III animals breathing air. These data suggest that a) glucagon release is caused by acute oxygen deficiency, and b) the hypoxic response is largely adrenergically mediated with the major role played by the alpha-receptor.

Animals↗

Glucose infusion potentiates the acute insulin response to nonglucose stimuli during the infusion of somatostatin.

These studies assessed the ability of glucose infusions to potentiate the acute insulin response (AIR) to iv isoproterenol (12 micrograms), arginine (750 mg), or glucose (5 g) that was previously inhibited by an infusion of somatostatin (SRIF). SRIF (1.7 micrograms/min) markedly inhibited the AIR to isoproterenol (AIR before SRIF, 28 +/- 1 microU/ml; AIR during SRIF, 8 +/- microU/ml; P less than 0.025), arginine (AIR before SRIF, 6 +/- 2 microU/ml; AIR during SRIF, 1 +/- 1 microU/ml; P less than 0.01), and glucose (AIR before SRIF, 19 +/- 7 microU/ml; AIR during SRIF, 1 +/- microU/ml; P less than 0.05). The administration of a glucose infusion of 105 mg/min partially restored the AIR to isoproterenol and arginine. Glucose infused at 440 mg/min fully restored the AIR to both isoproterenol (AIR during SRIF plus glucose, 31 +/- 4 microU/ml) and arginine (AIR during SRIF plus glucose, 9 +/- 2 microU/ml). In contrast, the AIR to glucose was not affected by infusion of glucose (AIR during SRIF plus glucose, 0 +/- 1 microU/ml). In the absence of SRIF, glucose infusion potentiates the AIR to isoproterenol and arginine but not to glucose. Therefore, during SRIF infusion, glucose retains the ability to potentiate the AIR to nonglucose stimuli despite the loss of the ability to stimulate insulin release directly. These data suggest that the potentiating effects of glucose and the inhibiting effects of SRIF may be mediated by a common mechanism affecting insulin release.

Animals↗

Comparison of a colorimetric assay for glycosylated hemoglobin with ion-exchange chromatography.

Because levels of glycosylated hemoglobin (GHb) are increased in diabetes and reflect the previous metabolic control, clinicians and clinical investigators are finding increasing applications for measurements of GHb in diabetic patients. We report the characterization of a colorimetric assay procedure for GHb and compare its performance with that of a commonly used assay by ion-exchange chromatography. Although results of GHb determination by both methods correlate highly (r = 0.946, P less than 0.001), the two procedures estimate different glycosylated fractions. The colorimetric procedure is nonstoichiometric, requiring careful standardization of assay conditions, including the concentration of total hemoglobin in the assayed aliquot, to achieve precision and permit comparison of results. We characterized the effect of storage of hemolysates or packed erythrocytes on the subsequent determination of GHb by both methods. Determinations of GHb by the colorimetric method, but not by column chromatography, are reproducible on hemolysates or packed erythrocytes on the subsequent determination of GHb by both methods. Determinations of GHb by the colorimetric method, but not by column chromatography, are reproducible on hemolysates or packed erythrocytes stored frozen for at least 5 mo. A unique advantage of the colorimetric procedure is the capability to estimate GHb levels when variant hemoglobins, including fetal and sickle hemoglobins, are present.

Chromatography, Ion Exchange↗

Nerve conduction abnormalities in untreated maturity-onset diabetes: relation to levels of fasting plasma glucose and glycosylated hemoglobin.

The role of metabolic abnormalities in the development of diabetic neuropathy is controversial. To investigate the influence of hyperglycemia on nerve conduction, we studied 20 untreated maturity-onset diabetic patients and 23 normal control subjects of similar age. Nerve conduction velocity of motor (median, peroneal, and tibial) and sensory (median and sural) nerves in diabetic patients was significantly slowed and H-reflex latency time prolonged. Levels of fasting plasma glucose in diabetic subjects were correlated with slowed motor conduction velocity of the median, peroneal, and tibial nerves but not with sensory nerve conduction velocities. Levels of glycosylated hemoglobin, an index of long-term glycemia, were correlated with slowing of peroneal motor conduction velocity in diabetic patients. These associations could not be explained by patient age or duration of diabetes. These findings suggest that the degree of hyperglycemia of untreated maturity-onset diabetes contributes to the motor nerve conduction abnormalities in this disease.

Adult↗

Treatment of hypertriglyceridemia with para-aminosalicylic acid-C: a possible mechanism of action.

The effect of para-aminosalicylic acid-C (PAS-C, 8 g/day) on lipid metabolism was studied on a metabolic ward in nine subjects with primary endogenous hypertriglyceridemia. During 2 wk on a basal isocaloric liquid formula diet (40% fat, 45% carbohydrate), PAS-C reduced plasma triglyceride (-41.9 +/- 18.9%, p less than .01, -x +/- SD), cholesterol (-22.8 +/- 12.9%, p less than .005), and a very low density lipoprotein triglyceride (p less than .001) and cholesterol (p less than .01) levels without changing the cholesterol content of low density or high density lipoproteins. Similar effects occurred on a fat-free, 85% carbohydrate diet. Decreases in very low density lipoproteins correlated with changes in both total triglyceride (r = .99, p less than .01) and cholesterol (r = .70, p less than .05). Treatment with PAS-C reduced the plasma triglyceride removal rate related to lipoprotein lipase (-14.6 +/- 14.1%, p less than .02), but did not alter plasma postheparin lipolytic activity or the apparent Km for substrate-enzyme interaction. Kinetic data obtained during the prolonged heparin infusion fit the linearized Michaelis-Menten model for subjects with endogenous hypertriglyceridemia. The reduction in the plasma triglyceride concentration during PAS-C treatment was a function of the decrease in triglyceride removal rate (r = .74, p less than .025) without alternation in the maximal removal capacity related to lipoprotein lipase. This suggests that under the steady state conditions of these studies, the decrease in plasma triglyceride concentration was due to a reduction in endogenous triglyceride production. Free fatty acid metabolism, glucose homeostasis, fat absorption, and thyroid function did not change. These results suggest that PAS-C lowers plasma triglyceride and cholesterol levels in hypertriglyceridemic subjects reducing endogenous very low density lipoprotein production and/or secretion into the circulation.

Adult↗

Suppression of plasma catecholamines and flushing by clonidine in man.

Administration of the anti-hypertensive agent clonidine as a single (0.5 mg) oral dose or as multiple doses (0.2-0.4 mg/day for 4 days) markedly reduced plasma catecholamines (decrement = 81 +/- 3% and 68 +/- 5%, respectively; X +/- SE, % of basal; both P less than 0.001) in normal male volunteers. Five patients with various metabolic disorders showed similar responses. The absolute decrements in plasma catecholamines correlated significantly with basal catecholamine levels (P less than 0.001). Clonidine-induced decrements in mean arterial blood pressure correlated significantly with decrements in plasma catecholamines (P less than 0.001). The clonidine effect upon catecholamine levels was reversed by phentolamine (clonidine = -68 +/- 5%; clonidine with phentolamine = -1 +/- 16%). The decrements in catecholamines induced by clonidine in normal subjects were associated with increased sensitivity to the pressor effect of infusion of exogenous norepinephrine. In an analogous fashion flushing associated with endogenous adrenergic discharge was blocked by clonidine, whereas that due to exogenous catecholamines was intensified. These data are compatible with data in experimental animals suggesting that clonidine acts at least in part by interaction with a central alpha adrenergic receptor.

Adenoma, Islet Cell↗