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Insulin resistance does not change the ratio of proinsulin to insulin in normal volunteers.

Plasma glucose, insulin, and proinsulin concentrations were measured before and after an oral glucose challenge in 57 nondiabetic individuals. In addition, insulin-mediated glucose disposal was estimated by determining the steady state plasma glucose (SSPG) concentration after a 180-min iv infusion of somatostatin, insulin, and glucose. The plasma glucose concentration after oral glucose administration was used to divide the population into those with normal (n = 36) or impaired glucose tolerance (IGT; n = 21), and the 36 normal glucose-tolerant individuals were further subdivided into an insulin-sensitive (SSPG, < 9.0 mmol/L; n = 15) and an insulin-resistant (SSPG, > 10 mmol/L; n = 21) group. Fasting and postglucose load insulin concentrations were similar in the normal glucose-tolerant insulin-resistant and IGT groups, but were significantly higher (P < 0.02- < 0.001) than those in normal glucose-tolerant insulin-sensitive individuals. Fasting proinsulin concentrations were also higher (P < 0.002) in the normal glucose-tolerant insulin-resistant (15.1 +/- 1.5 pmol/L) and IGT (15.8 +/- 1.8 pmol/L) groups compared to those in normal glucose-tolerant insulin-sensitive volunteers (9.3 +/- 1.2 pmol/ L). However, the ratio of fasting proinsulin to insulin was identical in all three groups (0.12). When the three groups were combined, significant relationships (P < 0.001) existed between SSPG (degree of insulin resistance) and both fasting proinsulin (r = 0.59) and insulin (r = 0.66) concentrations, but not with the ratio of proinsulin to insulin (r = 0.03). These results demonstrate that fasting proinsulin and insulin concentrations are increased in insulin-resistant, nondiabetic subjects, and the more insulin resistant, the greater the increase. In contrast, the ratio of proinsulin to insulin did not vary as a function of insulin resistance. Thus, neither insulin resistance nor the need to secrete more insulin to maintain glucose tolerance necessarily leads to abnormal insulin processing by the beta-cell.

Administration, Oral↗

Physiological increase in plasma insulin concentration suppresses proinsulin secretion in normal controls but not in subjects with glucose intolerance.

Since insulin negatively controls its own secretion, we examined if insulin also inhibits the secretion of its precursor, proinsulin, in subjects with varying degrees of glucose tolerance. Under comparable hyperinsulinemia (50-70 microU/ml) achieved by the euglycemic insulin clamp technique, plasma C-peptide concentrations were equally suppressed to approximately 40-50% in nonobese subjects with normal glucose tolerance (NGT) (n = 13, 35.5 +/- 3.7%, M +/- SEM), borderline glucose intolerance (BGI) (n = 12, 46.7 +/- 5.6%), and non-insulin-dependent diabetes mellitus (NIDDM) (n = 12, 48.9 +/- 5.4%). In contrast, plasma proinsulin concentrations were slightly but significantly suppressed in NGT (4.1 +/- 0.2 to 3.7 +/- 0.2 pmol/L, P < 0.05), but not in patients with BGI (4.6 +/- 0.3 to 4.8 +/- 0.5 pmol/L, NS) and NIDDM (5.5 +/- 0.5 to 4.9 +/- 0.4 pmol/L, NS). The basal concentrations of proinsulin increased as glucose tolerance declined (P < 0.05 between NGT and NIDDM). These results suggest that the basal secretion of proinsulin by beta-cells seems relatively insensitive to insulin compared with C-peptide, and that the insulin-proinsulin feedback loop is disturbed in glucose-intolerant subjects. Therefore, a defective feedback inhibition of proinsulin secretion by insulin may be partly involved in the disproportionate increase of plasma proinsulin concentrations in patients with NIDDM.

Adult↗

Preferential release of proinsulin relative to insulin in non-insulin-dependent diabetes mellitus.

A radioimmunoassay, using an antiserum that is specific for human proinsulin, has been used to study the response of serum proinsulin to low (25 g) and high (75 g) oral glucose loads in non-obese patients with non-insulin-dependent diabetes mellitus (NIDDM). Diabetic patients were treated by diet only (N = 8) or were receiving oral anti-hyperglycemic agents (N = 8) and therapy was not interrupted during the study. In the fasted state, proinsulin concentrations were higher (P less than 0.05) in the drug-treated patients (31 +/- 3 pmol/l (SEM)) compared with age- and weight-matched healthy subjects (22 +/- 2 pmol/l; N = 10), but concentrations in the diet-treated patients 25 +/- 3 pmol/l) were not significantly different. Following 25 g and 75 g glucose loads, the rises in serum immunoreactive insulin and C-peptide concentrations in both groups of diabetic patients were impaired and delayed relative to those in the control subjects. The responses of serum proinsulin, however, were not significantly different in the NIDDM patients compared with controls at any time point up to 180 min except in the case of drug-treated patients receiving 25 g of glucose who had elevated (P less than 0.05) proinsulin concentrations at 150 min and 180 min after ingestion. It is concluded that NIDDM is not associated with an exaggerated release of proinsulin in response to glucose compared with healthy subjects, but the islets have maintained the ability to release proinsulin better than the ability to release insulin.

Adult↗

A major C-peptide deletion prevents secretion of a mutant human proinsulin from transfected monkey kidney cells.

The biosynthesis and secretion of human proinsulin and a mutant human proinsulin with a major deletion in the C-peptide, (des 38-62)proinsulin, was studied in monkey kidney cells (Cos-7) transfected with cDNAs encoding the respective normal or mutant human preproinsulins. Transfected cells were labelled with [3H]leucine, and insulin-like material was immunoprecipitated and analysed by sodium dodecyl sulphate-polyacrylamide gel electrophoresis. It was found that the prepeptide was removed from both the normal and mutant preproinsulins, and that there was no further processing to insulin. The normal proinsulin was rapidly released from the transfected cells, with little intracellular accumulation, while the mutant proinsulin was retained within the cell, with only small quantities of radio-labelled material in the medium. The intracellular mutant proinsulin was membrane bound and located predominantly within a microsomal fraction. These results suggest that C-peptide plays an important role in the efficient transfer of proinsulin through the early stages of the secretory pathway.

Amino Acid Sequence↗

Processing and release of human proinsulin-cleavage products into culture media by different engineered non-endocrine cells: a specific assessment by capillary electrophoresis.

The aim of this study was to compare the metabolic pathway to mature insulin through the intermediate forms (32-33 split, 65-66 split, des31,32 and des64,65) in human or murine cells engineered for the release of wild-type human proinsulin and in a genetically mutated one, in the search for a new approach for an insulin-dependent diabetes mellitus cure by gene therapy. Primary human fibroblasts, myoblasts and stabilized cell lines (HepG2 and NIH3T3) were transduced either with a retroviral vector coding for wild-type proinsulin or for a genetically mutated one, carrying cleavage sites sensitive to furin. The pattern of all the proinsulin cleavage products released into the cell culture supernatants was analyzed by capillary electrophoresis. All the cells transduced with the wild-type gene released intact proinsulin. HepG2 released a considerable amount of 65-66 split and des64,65, while primary myoblasts released all the intermediate forms and a limited amount of mature insulin. All the cells transduced with a furin-sensitive proinsulin gene released a higher amount of mature insulin (23-59% conversion yield) than the cells expressing wild-type proinsulin, whereas the total insulin was nearly constant. Only primary cells released all the cleavage products. Screening a wide variety of non-endocrine cells has revealed a large difference in the processing and release of immature and mature insulin forms, pointing to human hepatic cells as the most efficacious. Capillary electrophoresis provided on-line and in a single run a complete overview of the proinsulin metabolic pathway in different cells.

3T3 Cells↗

Insulin-like action of proinsulin on rat liver carbohydrate metabolism in vitro.

Short-term effects of human proinsulin on metabolic rates and its long-term action on enzyme induction were studied in primary cultures of rat hepatocytes and in the perfused rat liver, and compared with the effects of bovine insulin. In the perfused rat liver, proinsulin decreased the glucagon-dependent increase of glycogenolysis. The action of 0.5 nM glucagon was almost completely suppressed by 100 nM proinsulin. Proinsulin and insulin showed similar potency. In cultured rat hepatocytes, proinsulin stimulated glycolysis up to fivefold with a half-maximal effective dose of 30 nM. Proinsulin induced the key glycolytic enzymes glucokinase and pyruvate kinase by twofold and antagonized the glucagon-dependent induction of phosphoenolpyruvate carboxykinase with a half-maximal effective dose at 3 nM. For the effects in cultured hepatocytes, about 100-fold higher concentrations of proinsulin than of insulin were required.

Animals↗

Inhibition of glycogenolysis and glycogen phosphorylase by insulin and proinsulin in rat hepatocyte cultures.

The inhibitory action of insulin and proinsulin on basal and glucagon-activated glycogenolysis was studied in cultured rat hepatocytes containing [14C]glycogen. Insulin or proinsulin given as sole hormones in the presence of 5 mM glucose decreased basal release of [14C]glucose from [14C]glycogen to 20%. Half-maximal effective concentration of insulin was approximately 0.15 nM and of proinsulin was approximately 5 nM. Inhibition of [14C]lactate release from [14C]glycogen required slightly higher hormone concentrations with a similar difference in potency for insulin and proinsulin. The glucagon-stimulated release of [14C]glucose was completely blocked by insulin or proinsulin with half-maximal effective concentrations of approximately 0.2 and approximately 8 nM, respectively. In contrast, release of [14C]lactate in the presence of glucagon was increased slightly by insulin and proinsulin. Basal and glucagon-activated phosphorylase activity was inhibited by approximately 50% in a dose-dependent manner by both hormones, with differences in potency similar to those for the inhibition of glycogenolysis. These data point to a direct regulatory role of insulin in the control of hepatic glycogen breakdown even when acting as sole hormone. The results do not support the notion of a preferential inhibitory potency of proinsulin on hepatic glycogenolysis.

Animals↗

Glucose-regulated proinsulin processing in isolated islets from rat pancreas.

We demonstrated previously that the conversion rate of proinsulin to insulin in pancreatic islets progressively increased after prolonged prior exposure to glucose (11 mM) and that this effect could be blocked by cycloheximide. This study was designed to characterize further the time course and regulation of the proinsulin conversion process. The effects of prior exposure to glucose on proinsulin conversion were dose dependent (Km, approximately 7 mM glucose) and time dependent, taking approximately 3 h to reach the maximum rate. Glucose added at or after the subsequent [3H]leucine pulse was ineffective. Mannoheptulose, added during a 3-h exposure with glucose (11 mM), prevented glucose-induced activation of the proinsulin conversion process. L-Leucine (20 mM) was as effective as 11 mM glucose in activating conversion, whereas 2-alpha-ketoisocaproic acid (20 mM) or phorbol ester (50 nM) had little effect. Activation of proinsulin conversion by a 24-h exposure to glucose (11 mM) was reversed by a subsequent 3-h prior exposure to cycloheximide. alpha-Amanitin, an inhibitor of mRNA synthesis, did not influence the glucose-induced activation of proinsulin conversion when present during a 3-h exposure to glucose; however, it completely inhibited glucose-stimulated conversion when present during 24 h exposure. Results suggest that activation of the proinsulin conversion process is regulated by glucose metabolism rather than the glucose molecule per se and that other, but not all, secretagogues are effective. Conversion may require prior synthesis of a pool of converting enzyme(s) or other regulatory proteins whose turnover is relatively rapid (approximately 33 h) and whose mRNA is more stable (to 24 h).

Amanitins↗

Kinetics of proinsulin conversion in human islets.

Islets isolated from human cadaver pancreas were pulse-labeled (10 min with [3H]leucine) and then incubated for a 180-min chase. Islets and chase medium were collected every 15 min and analyzed by reversed-phase HPLC to quantify the percentage of radioactively labeled proinsulin, conversion intermediates, and fully processed insulin. Release of proinsulin-related labeled products into the chase medium was < 10% of total. Whereas 50% of labeled proinsulin had been lost by conversion within 45 min, fully processed insulin only appeared with a half-time of 100 min. This discrepancy is attributable to accumulation of radioactive conversion intermediates. Des 64.65 split proinsulin was a minor component, reaching a maximum of 5.2 +/- 1.7% (n = 4) at 60 min of chase. By contrast, des 31.32 split proinsulin--and a truncated form lacking the first three residues of C-peptide--rose progressively to 29.3 +/- 1.4% by 75 min, and declined thereafter. The accumulation of des 31.32 split proinsulin rather than the des 64.65 split form during the conversion of human proinsulin reflects slower conversion at the C-peptide/A-chain than at the B-chain/C-peptide junction, and is consistent with the appearance of this particular conversion intermediate in the circulation.

Adult↗

Proinsulin secretion during the first 3 years after diagnosis in diabetic patients with and without islet cell antibodies.

OBJECTIVE: To evaluate proinsulin secretion in different types of NIDDM. RESEARCH DESIGN AND METHODS: Proinsulin and insulin were evaluated at diagnosis of diabetes and 3 years later (fasting and after stimulation with intravenous glucose and glucagon) in 10 NIDDM patients without islet cell antibodies (ICAs) at diagnosis (age 52 +/- 4 years), 11 NIDDM patients with ICAs at diagnosis (age 50 +/- 5 years), and 21 healthy control subjects (age 53 +/- 4 years). RESULTS: At diagnosis, fasting proinsulin was higher in NIDDM patients without ICAs than in control subjects (39.6 +/- 10.0 vs. 12.8 +/- 1.6 pmol/l, P < 0.01). Proinsulin response to intravenous glucose decreased in NIDDM patients with ICAs (from 35.6 +/- 6.2 to 13.5 +/- 5.4 pmol/l, P < 0.05), but remained unchanged in those without ICAs. At 3 years after diagnosis, fasting proinsulin (10.0 +/- 3.7 vs. 59.1 +/- 17.0 pmol/l) and proinsulin responses to intravenous glucose (13.5 +/- 5.4 vs. 103.9 +/- 35.1 pmol/l) and to intravenous glucagon (7.4 +/- 3.9 vs. 36.0 +/- 7.7 pmol/l) were much lower (P < 0.01) in NIDDM patients with ICAs than in those without ICAs. CONCLUSIONS: After diagnosis of diabetes, proinsulin secretion decreases significantly in NIDDM patients with ICAs and remains constant in those without.

Autoantibodies↗

Cross-sectional and prospective associations between proinsulin and cardiovascular disease risk factors in a population experiencing rapid cultural transition.

OBJECTIVE: To examine cross-sectional and prospective associations between proinsulin and cardiovascular disease risk factors using data from a population-based study of type 2 diabetes among Native Canadians. RESEARCH DESIGN AND METHODS: Between 1993 and 1995, 72% of eligible members of a Native Canadian community participated in a baseline diabetes prevalence survey. Fasting samples were collected for glucose, C-peptide, proinsulin, lipids, and apolipoproteins. A 75-g oral glucose tolerance test was administered, and a second sample for glucose was drawn after 120 min. Blood pressure and waist circumference were determined. In the present study, subjects with normal glucose tolerance (NGT) (n = 505) and impaired glucose tolerance (IGT) (n = 74) were included in cross-sectional analyses. In 1998, 95 individuals who had IGT or NGT at baseline with an elevated 2-h glucose concentration (> or = 7.0 mmol/l) participated in a follow-up evaluation using the protocol used at baseline. Cross-sectional and prospective associations between proinsulin and cardiovascular risk factors were assessed using correlation and multiple linear regression analyses. RESULTS: After adjustment for covariates including age, sex, C-peptide, waist circumference, and glucose tolerance status, fasting proinsulin concentration was significantly associated with concurrently measured lipid and apolipoprotein concentrations (triglycerides: r = 0.18, P < 0.0001; total cholesterol: r = 0.10, P = 0.02; LDL cholesterol: r = 0.11, P = 0.01; HDL cholesterol: r = -0.16, P = 0.0002; apolipoprotein (apo) B: r = 0.17, P < 0.0001; apoAI: r = -0.11, P = 0.008). In the adjusted prospective analysis, baseline triglycerides, HDL cholesterol, and apoB were associated with changes over time in proinsulin (r = 0.23, P = 0.04; r = -0.30, P = 0.01; r = 0.23, P = 0.04; respectively). CONCLUSIONS: These results confirm previously reported cross-sectional associations between proinsulin and lipid concentrations. In addition, an unexpected association between baseline lipids and proinsulin change was documented.

Adult↗

Proinsulin concentration is an independent predictor of all-cause and cardiovascular mortality: an 11-year follow-up of the Hoorn Study.

OBJECTIVE: High proinsulin concentration may be a better predictor for cardiovascular disease (CVD) mortality than insulin concentration. Previous observations may have been confounded by glucose tolerance status or lack of precision because of high intraindividual variability. We investigated the longitudinal relation of means of duplicate measurements of insulin and proinsulin with all-cause and CVD mortality in a population-based cohort taking glucose tolerance status into account. RESEARCH DESIGN AND METHODS: Fasting and post-75-g glucose-load (2-h) glucose, insulin, and proinsulin values were determined in duplicate on separate days in 277 participants with normal glucose metabolism, 208 participants with impaired glucose metabolism, and 119 newly detected patients with type 2 diabetes of the Hoorn Study. Insulin resistance and beta-cell function were estimated by homeostasis model assessment (HOMA-IR and HOMA-B, respectively), and the fasting proinsulin-to-insulin ratio was calculated. Subjects were followed with respect to mortality until January 2003. RESULTS: Fasting proinsulin levels were significantly associated with all-cause and CVD mortality. The hazard ratios (HRs) per increase in interquartile range adjusted for age and sex were 1.21 (95% CI 1.04-1.42) for all-cause mortality and 1.33 (1.06-1.66) for CVD mortality. Adjustment for glucose tolerance status and HOMA-IR did not substantially change the associations. CONCLUSIONS: Fasting proinsulin was associated with all-cause and CVD mortality, independent of glucose tolerance status and insulin resistance and largely independent of other CVD risk factors. Proinsulin might play a role in the relationship between insulin resistance and CVD.

Aged↗

Increased blood proinsulin and decreased C-peptide levels in patients with pancreatic cancer.

BACKGROUND/AIMS: Abnormal glucose tolerance during oral glucose tolerance test (OGTT) is frequently observed in patients with pancreatic cancer. The abnormality shown in previous studies, however, was characterized mainly by analyses based on immunoreactive insulin or C-peptide response during OGTT, despite their cross-reactivity with proinsulin. The mechanisms responsible for glucose intolerance in patients with pancreatic cancer remain controversial. METHODOLOGY: Both proinsulin and C-peptide responses during 75 g of OGTT were determined without influence of immunologic cross-reactivity in 32 patients with pancreatic cancer and 32 control subjects of similar age, sex, fasting blood glucose levels, and OGTT pattern. RESULTS: The pancreatic cancer patients had higher proinsulin and lower C-peptide levels than the control subjects both in the non-diabetic and diabetic groups. The ratio of the sum of five proinsulin values observed at 0, 30, 60, 120, and 180 min to that of the five C-peptide values (sigma proinsulin/sigma C-peptide ratio) was 6.1 +/- 3.2% in patients with pancreatic cancer and 2.5 +/- 1.0% in control subjects (p < 0.05), while it was not associated with the diabetic pattern in OGTT. The sigma proinsulin/sigma C-peptide ratio was not associated with tumor size, location or resectability but was associated with the number of islets left within or close to cancer stroma. The increased sigma proinsulin/sigma C-peptide ratio decreased after tumor removal. CONCLUSIONS: Patients with pancreatic cancer are characterized by increased proinsulin secretion and decreased C-peptide production during OGTT probably due to impaired proinsulin conversion. Although further studies are required in a large scale of patients, measurement of proinsulin and C-peptide levels during OGTT should serve as an early marker to identify high risk groups of the disease.

Adenocarcinoma↗

[Proinsulin and insulin secretion in obese females before and after administration of metformin].

In 49 normal and overweighty women the basal and reactive proinsulin and insulin level as well as serum cholesterol and triglycerides were determined before and after the application of N,N-dimethylbiguanide-hydrochloride (metformin, Glucophage retard-R). The proinsulin fraction of the basal total insulin is 70 percent in normal women. With increasing overweight the percentage of proinsulin decreases in favor of insulin. Stimulation with 100 g oral glucose, in analogy to the total insulin, significantly increased proinsulin levels, remaining, however, below the insulin levels. Accordingly the increased secretion of total insulin in overweighty persons consists mostly of insulin and to a lesser degree of proinsulin. Additionally there exists a significant correlation between the triglycerides and the degree of overweight. After 4 weeks application of 1.7 g metformin daily the weight reduction reached on an average 1.4 kg, after 16 weeks 5.2 kg. In relation to the weight reduction lower proinsulin and insulin levels were noticed before and after stimulation with glucose. Even those test persons who did not lose weight under metformin showed lower proinsulin and insulin levels. It might be that metformin leads to a slow-down in glucose absorption and as a consequence to a decrease of insulin secretion. Lower triglyceride values after treatment with metformin not only were a sign of weight reduction: biguanides also influence the fat metabolism independently of the carbohydrate metabolism. Additional to the reduction diet the treatment with metformin seems to be very appropriate for overweighty patients with hyperinsulinism and hypertriglyceridemia.

Adult↗

[Studies on genetic engineering of human insulin-purification and characterization of human proinsulin and insulin].

E. coli DH 5 alpha cells harboring a plasmid pWR 590-BCA 4 for fused human proinsulin production were cultured. The fused human proinsulin was isolated from the fermented cells and then subjected it to cleavage with BrCN. The cleaved product was then converted to crude proinsulin-S-sulfonate using oxidative sulfitolysis. The isolation of human proinsulin-S-sulfonate was accomplished by ion exchange chromatography on QAE-sephadex A-25, followed by gel filtration on sephadex G-50. The purified human proinsulin-S-sulfonate was folded using a disulfide interchange method. The folding mixture was then chromatographed on sephadex G-50 and purified proinsulin was obtained. The proinsulin was then converted to human insulin and C-peptide by a combination cleavage with trypsin and carboxypeptidase B. The total yield of human insulin was about 5 mg/L The Zinc insulin crystals were obtained with amorphous human insulin using citrate method. The amino acid composition N-terminal sequences as well as C-terminal amino acid residues are in agreement with expected results. The hypoglycemic activity of purified human insulin is 26-27 U/mg, as judged by mouse convulsion assay, and the RIA activity is about 99% of that of porcine insulin.

Cloning, Molecular↗

Clinical and laboratory evaluation of a new specific ELISA for intact proinsulin.

Intact proinsulin is a marker for pancreatic beta-islet cell secretion status, and elevated levels indicate insulin resistance of type 2 diabetic patients with a high diagnostic specificity. Determination of intact proinsulin in fasting morning plasma samples can be used to establish and/or identify the optimal anti-diabetic treatment as well as to monitor a potential protective treatment effect on beta-islet cell dysfunction. For widespread use as a routine marker, simple and reliable assays must become available for measurement in clinical laboratories. This study was performed to evaluate a new ELISA method specific for intact proinsulin determination compared with a commercial chemiluminescence test. Intra-assay imprecision was determined to be 2.4 - 5.5% (inter-assay: 3.2 - 4.3%). A sample cohort derived from non-diabetic healthy subjects (66 female, 29 male, age (median, range): 37 (19-77) years) was used to calculate a reference range for non-diabetic individuals of 1.8 - 11.0 pmol/l. The comparison of samples obtained from 7 diabetic patients (2 female, 5 male, age: 66 (44-72) years) from oral glucose tolerance tests resulted in an excellent correlation between the ELISA and the chemiluminescence assay (r = 0.989; p<0.001). A sample stability investigation with different sample specimens revealed that intact proinsulin is stable for two days at room temperature in EDTA whole blood and heparin whole blood tubes without centrifugation, while serum samples should be centrifuged immediately and frozen to retain intact proinsulin concentrations. As EDTA whole blood is the routine sample specimen for determination of HbA1c, a marker frequently measured in diabetic patients, this finding underlines the practicability of analyzing intact proinsulin from the same blood specimen. In conclusion our study revealed that the new ELISA shows excellent agreement with the commonly used chemiluminescence immunoassay. The ELISA can easily be introduced into routine laboratories and does not require any further specific instrumentation. Our additional finding that intact proinsulin is stable in EDTA whole blood samples, which can be obtained from the routine.sample for HbA1c measurement, is increasing the probability of the acceptance of this marker for routine assessment of beta-cell dysfunction and insulin resistance in type 2 diabetes.

Adult↗

Human proinsulin: bioactivity and pharmaco-kinetics after intravenous and subcutaneous administration.

The hypoglycemic actions of biosynthetic human proinsulin and human insulin (1 IU insulin/kg b.w. and about equimolar amounts of proinsulin) were studied after intravenous and subcutaneous injection in rabbits. Blood samples were taken up to four hours after injection for the determination of blood glucose and immunoreactive levels of both insulin and human C-peptide. For the determination of human C-peptide, serum taken after proinsulin injection was divided into two fractions. One was examined directly by the human C-peptide radioimmunoassay and the other after incubation with a protein-A-sepharose coupled insulin antibody to find "free human C-peptide". In amounts equimolar to 1 IU insulin/kg b.w., proinsulin exerted an about one third stronger hypoglycemic action (area under curve estimation) after s.c. compared to i.v. injection. Proinsulin-induced hypoglycemia did not last longer after intravenous administration than that induced by intravenous insulin. Although subcutaneous proinsulin did not show the same maximum decrease of blood glucose as subcutaneous insulin, its action was significantly prolonged (up to 180 min). Specific measurement of free human C-peptide showed no evidence of conversion of proinsulin to insulin and C-peptide.

Animals↗

Hypoglycaemic effect of proinsulin and insulin in intact and eviscerated rats.

The hypoglycaemic potency of biosynthetic human proinsulin and human insulin was studied in intact anaesthetized rats and in eviscerated hepatectomized rats, the latter serving as model for an in vivo muscle/fat tissue preparation. Intravenous dose response curves demonstrated a similar about 5-times smaller potency of proinsulin in both experimental conditions (half-maximal effective dose in intact rats for insulin 3.5, for proinsulin 17.5 nM/kg body weight; in eviscerated rats for insulin 3.6, for proinsulin 18.5 nM/kg). In intact rats hepatic glycogen content 2 h after hormone injection was higher in proinsulin than in insulin treated animals despite similar preceding hypoglycaemia which might suggest a preferential inhibitory action of proinsulin on hepatic glycogen breakdown (135 mumol glycosyl units/g liver for proinsulin-injected and 82 mumol glycosyl units/g liver for insulin-injected rats at half-maximal hypoglycaemia).

Animals↗