Characterization of response of circulating glucagon to intraduodenal and intravenous administration of amino acids.

Studies were carried out to determine if hyperaminoacidemia stimulates the secretion of pancreatic glucagon, and, if so, to evaluate the effect of endogenous and exogenous pancreozymin and of hyperglycemia upon this response. The intravenous administration to 16 dogs of 1 g/kg of a 10 amino acid mixture over a 60 min period raised amino nitrogen to a mean level of 13.5 mg/100 ml; mean pancreaticoduodenal vein insulin rose from 84 to 459 muU/ml and glucagon from 1.1 to 2.7 mmug/ml. Further augmentation of both insulin and glucagon secretion was achieved during hyperaminoacidemia by infusing pancreozymin. Since endogenous pancreozymin is known to be stimulated by amino acids in the gut, it seemed possible that intraduodenal loading of amino acids would elicit a greater insulin and glucagon response than could be explained by the accompanying hyperaminoacidemia. The intraduodenal administration of 1 g/kg of the amino acid mixture was followed by substantial hyperinsulinemia and hyperglucagonemia, which frequently anticipated the hyperaminoacidemia, and in many of the dogs the ratio of hormone rise to amino nitrogen rise was greater after intraduodenal than after the intravenous route of amino acid administration in the same animal. Intraduodenal administration of amino acids did not cause measurable release of intestinal glucagon-like immunoreactivity into the mesenteric vein plasma. Hyperglycemia induced by constant glucose infusion prevented aminogenic hyperglucagonemia and even suppressed the augmenting action of pancreozymin; sudden termination of the infusion with continued amino acid infusion was associated with a striking rise in glucagon. It is concluded (a) that hyperaminoacidemia stimulates pancreatic glucagon secretion, (b) that aminogenic hyperglucagonemia is augmented by the infusion of pancreozymin, (c) that intraduodenal administration of amino acids stimulates pancreatic glucagon secretion without measurable release of glucagon-like immunoreactivity into the mesenteric vein, and (d) that hyperglycemia prevents aminogenic hyperglucagonemia even during augmentation with pancreozymin. This conclusion suggests that the prevention of hypoglycemia during amino acid-induced insulin secretion may be an important function of glucagon.

Characterization of the responses of circulating glucagon-like immunoreactivity to intraduodenal and intravenous administration of glucose.

The effects of ingested and infused glucose upon circulating glucagon-like immunoreactivity (GLI) were compared in 14 triply catheterized conscious dogs. Within 60 min after the intraduodenal administration of 2 g/kg of glucose, the mean level of glucagon-like immunoreactivity in the vena caval plasma more than doubled, whereas after intravenous infusion of the same dose over a 90 min period no change in the mean vena caval level was observed; during glucose infusion mean glucagon-like immunoreactivity in the pancreatic venous effluent declined, suggesting that hyperglycemia suppresses rather than stimulates pancreatic glucagon secretion. To determine if the rise in glucagon-like immunoreactivity that occurs during glucose absorption was of pancreatic origin, the effect of pancreatectomy performed 1 hr after the intraduodenal administration of glucose was determined. Although circulating insulin disappeared after resection of the pancreas, the level of glucagon-like immunoreactivity continued to rise, establishing its extrapancreatic origin. In other experiments, measurements of Glucagon-like immunoreactivity in plasma obtained simultaneously from pancreaticoduodenal and mesenteric veins and from the vena cava revealed the increment after intraduodenal glucose loading to be greatest in the mesenteric vein in 8 of 12 experiments, favoring the gut as the likely source of the rise. To characterize gut glucagon-like immunoreactivity, acid-alcohol extracts of canine jejunum were compared with similar glucagon-containing extracts of canine pancreas with respect to certain physical and biological properties. On a G-25 Sephadex column the elution volume of the jejunal immunoreactivity was found to be smaller than that of glucagon, which suggested a molecular size at least twice that of pancreatic glucagon. Furthermore, the in vivo and in vitro biological activities of the eluates containing jejunal glucagon-like immunoreactivity appeared to differ from those of eluates containing pancreatic glucagon. The jejunal material lacked hyperglycemic activity when injected endoportally into dogs, was devoid of glycogenolytic activity in the isolated perfused rat liver, and did not increase hepatic 3',5' cyclic adenylate in the perfused liver; however, like glucagon it appeared to stimulate insulin release. It seems quite clear the material in intestinal extracts either is a different substance or a different form from that of true pancreatic glucagon, although it crossreacts in the radioimmunoassay with antibodies to glucagon. It is concluded, (a) that hyperglycemia does not stimulate and probably suppresses the secretion of pancreatic glucagon; (b) that during intestinal absorption of glucose, a rise in glucagon-like immunoreactivity occurs; (c) this immunoreactivity is derived from an extrapancreatic site, probably the gut; (d) that the glucagon-like immunoreactivity extractable from jejunum is not the same as pancreatic glucagon but is a larger molecule devoid of hyperglycemic and glycogenolytic activity, a cross-reactant in radioimmunoassay for glucagon; and (e) that the eluate in which jejunal immunoreactivity is contained can stimulate insulin release in conscious dogs.

The role of aminogenic glucagon secretion in blood glucose homeostasis.

Hyperaminoacidemia is a powerful stimulus of pancreatic glucagon secretion. These studies were designed to elucidate the role of aminogenic hyperglucagonemia in glucoregulation. Conscious dogs with previously implanted indwelling venous catheters were employed. The results support the view that a role of glucagon is to limit blood glucose decline during hyperaminoacidemia.First, a significant negative correlation between the area of glucagon increment during the 1st 20 min of a 10 amino acid infusion and the maximum fall in glucose concentration was observed. Second, when endogenous glucagon secretion was suppressed by means of a continuous glucose infusion, hyperaminoacidemia induced a maximal glucose decline which averaged 35 mg/100 ml, differing significantly from mean maximal fall of 3 mg/100 ml, which normally occurs in the presence of endogenous hyperglucagonemia. Third, when, during hyperglycemic suppression of endogenous glucagon secretion, 50 mmug of exogenous glucagon/min was infused via the mesenteric vein with the amino acids, the fall in glucose was reduced to an average of 5 mg/100 ml. Similarly when pancreozymin, administered during the combined infusion of glucose and amino acids, overcame glucose suppression of endogenous glucagon secretion, plasma glucose did not fall. Similar results were obtained when aminogenic hyperglucagonemia was prevented by other means. Hyperlipacidemia, induced by infusing a triglyceride emulsion and giving heparin injections, also suppressed aminogenic hyperglucagonemia in two of four experiments; in these two dogs glucose fell 15 and 11 mg/100 ml. In a final group of experiments, the canine pancreas was resected except for the uncinate process, which is virtually devoid of alpha-cells. In two dogs, in which this procedure resulted in zero portal venous glucagon levels, the administration of amino acids and/or pancreozymin resulted in a glucose decline of 14 and 16 mg/100 ml, despite the reduced beta-cell population resulting from the subtotal pancreotectomy. It thus appears that the secretion of pancreatic glucagon during hyperaminoacidemia in association with insulin secretion, serves to limit the decline of glucose concentration.

Dietary intake and hyperlipidemia in controlled diabetic outpatients.

Statistical analyses were performed in order to determine the effects of the control of the diabetes as well as the food intake on serum lipid levels of 73 diabetic outpatients. They had had elevated fasting blood glucose levels, mostly complicated by various grades of hyperlipidemia, before the initiation of treatment. Hyperlipidemia was found to be ameliorated in nearly half of those patients after the start of diabetic treatment. However, the elevation of serum triglyceride persisted in 30 per cent of controlled diabetics, and no differences were found in occurrence of hypertriglyceridemia between diet-treatment group, sulfonylurea group, biguanide group, combined group and insulin group. Estimation of diet intake revealed that the controlled hypertriglyceridemic patients consumed slightly (but significantly) greater amounts of sucrose, alcohol, and total calories than the controlled normotriglyceridemic patients. In addition to such inadequate diet consumptions, the tendency to be overweight and the subtle increment of fasting blood glucose levels were also shown to have contributed to hypertriglyceridemia. It is thus concluded that the lipid disorder in controlled diabetic outpatients is the result of multifactorial influences and that well-conducted diet therapy and stricter regulation of blood glucose are essential in the management of posttreatment hyperlipidemia.

Glucagon response to arginine after treatment of diabetes mellitus.

To investigate the aminogenic glucagon response in diabetes mellitus, arginine infusion tests were carried out on twenty-four diabetic patients before and after treatment. Eleven healthy men served as a control group. Plasma glucagon was measured by radioimmunoassay using an antiserum, G21, specific for pancreatic glucagon. Out of twenty-four patients, five were treated with diet alone, eight with sulfonylurea, and eleven with insulin. In all these diabetic groups, the glucose tolerance improved after treatment for diabetes mellitus, while the insulin response to the glucose did not show any remarkable change. The fasting levels of the plasma glucagon did not differ from that of the normal subjects both before and after treatment. Hyperresponsiveness of the plasma glucagon to arginine infusion was observed in all diabetic groups, in comparison with that of the normal controls. The exaggerated response of the plasma glucagon to arginine was lowered following appropriate treatment in each diabetic group. However, as far as the changes in glucagon area during the arginine test are concerned, the aminogenic hyperresponsiveness of the plasma glucagon was reduced prominently in the diabetic group treated with sulfonylurea. The relationship between the response of glucose and plasma insulin and between glucose and glucagon to arginine was investigated, and the importance of the changes in the insulin:glucagon ratio was emphasized. Moreover, the possibility that long-term administration of a sulfonylurea may reduce an exaggerated glucagon response to arginine was discussed.

Interactions of obesity and glucose-stimulated insulin secretion in familial hypertriglyceridemia.

Plasma lipids and lipoproteins, glucose tolerance, plasma insulin response to glucose load, and liver function were examined in 81 relatives of 12 index cases with primary endogenous hypertriglyceridemia, hyperinsulinemia, and hepatic steatosis, as well as in 90 nonrelatives, including the spouses, as controls. Insulin hypersecretion (with or without glucose intolerance), endogenous hypertriglyceridemia, and abnormal liver function suggesting hepatic steatosis were shown to exist in the relatives mostly in combined fashion. Correlation analysis and stepwise multiple regression analysis revealed that the combined disorder developed on the basis of obesity. The incidence of diabetes mellitus was significantly high in the relatives (14.8 per cent) as compared with the normal Japanese population (3.5 per cent). Although the vertical transmission of the combined disorder was noted in almost all pedigrees, the frequency distribution analysis of insulin response, glucose tolerance, and plasma triglyceride showed the histograms of these variables similarly skewed to the right as compared with those of the controls, with no apparent bimodality. In view of the hitherto suggested role of insulin in triglyceride metabolism, it is concluded that hyperinsulinemia coupled with obesity seems to be the basic trait of this form of familial hypertriglyceridemia and hepatic steatosis, though the mode of transmission remains to be elucidated.

Effects of cold exposure on insulin and glucagon secretion in sheep.

The effectiveness of cold exposure on the secretion of insulin and glucagon were examined using five adult sheep. Endocrine responses were studied in a warm environment and after cold exposure (0 C) from 4-19 days. Compared to levels at room temperature, basal plasma glucose levels were elevated during cold exposure, but basal levels of plasma insulin and glucagon were unchanged. Cold exposure significantly decreased the early insulin response to a primed iv infusion of glucose. Plasma glucose and glucagon levels during glucose infusion were unaffected by cold exposure. The decrease in plasma glucose after iv insulin injection (0.2 U/kg BW) was greater during cold exposure than at room temperature. Butyrate injection (0.625 mmol/kg, iv) resulted in a significantly lower secretion of both insulin and glucagon in the cold than in the warm environment. The glucagon response to arginine infusion (0.5 g/kg over 30 min, iv) was elevated by cold exposure, whereas the insulin response to arginine tended to be reduced. Propranolol infusion (20 micrograms/kg . min, iv) caused a slight inhibition of insulin secretion in the cold environment, but did not affect glucagon levels in either the cold or warm environment. Phentolamine infusion (20 micrograms/kg . min, iv) inhibited glucagon secretion, particularly in the cold environment, and caused a markedly greater stimulation of insulin secretion in the cold. It is concluded that cold exposure insufficient to cause hypothermia decreases insulin secretion in response to a variety of stimuli. Effects of cold on glucagon secretion depend upon the stimulating agent used.

Abnormal response of pancreatic glucagon to glycemic changes in diabetes mellitus.

In order to determine pancreatic alpha cell function in diabetes mellitus, plasma glucagon responses to either an oral glucose load or insulin-induced hypoglycemia were investigated. Plasma glucagon in 6 normal control subjects fell significantly after the administration of glucose, whereas the levels of plasma glucagon did not decrease after glucose ingestion in patients with diabetes mellitus. In the group with severe diabetes, whose fasting blood glucose exceeded 200 mg/100 ml, the plasma glucagon level rose after glucose administration instead of decreasing. In 6 patients with diabetes mellitus, plasma glucagon did not decrease but rather increased during a glucose tolerance test which was performed after treatment with insulin and/or diet. In 6 control subjects, there was a remarkable rise of plasma glucagon in response to insulin-induced hypoglycemia. In contrast, no significant rise in plasma glucagon was demonstrated in 19 diabetic subjects undergoing intravenous insulin test. Seven patients, in whom an insulin test was repeated after treatment with insulin, sulfonylurea, or diet had a small rise in peak plasma glucagon and an increase in the integrated area under the glucagon response curve. It is concluded that the abnormal glucagon response to changes in blood glucose might be a primary defect in diabetes mellitus.

Enzyme immunoassay of pancreatic glucagon at the picogram level using beta-D-galactosidase as a label.

An enzyme immunoassay of pancreatic glucagon was established by using E. coli beta-D-galactosidease [EC 3.2.1.23] as a marker. In order to increase the sensitivity of the immunoassay, different peptides obtained from glucagon fragments were used to produce the enzyme conjugate and the immunogen. Antiserum N6E raised against C-terminal fragment peptide (15-29) could be diluted to more than 1 : 100,000 in the assay and was highly specific for pancreatic glucagon. The antiserum reacted well with the C-terminal fragment peptide (21-29) as well as another fragment peptide (15-29) and pancreatic glucagon. The enzyme immunoassay using antiserum N6E and fragment peptide (21-29)-enzyme conjugate could detect as little as 1 to 2 pg of glucagon. The mean recovery of glucagon added to serum specimens was 104% and the coefficients of variation were 3.7-14.5% (within assay) and 9.0-18.5% (between assay).

Gastric acid secretion and gut hormone release in patients undergoing pancreaticoduodenectomy.

The changes in gastric acid secretion and gut hormone release were investigated in 11 patients who underwent pancreaticoduodenectomy. The amount of acid output showed normoacidity before surgery and hypoacidity after surgery. No peptic ulcers were detectable after surgery. Plasma gastrin levels were markedly reduced after surgery both in the fasting state and after a test meal loading. Although fasting plasma levels of both gastric inhibitory polypeptide (GIP) and insulin after surgery were close to those before surgery, the response of these hormones to the meal was significantly reduced after surgery. On the other hand, blood glucose concentrations increased gradually after feeding, and the elevation was greatly prolonged after surgery compared with preoperative levels. From these results, it is concluded that peptic ulcer will not occur if subtotal gastrectomy is performed during Whipple's procedure. It is presumed that the diminished release of gut hormones such as gastrin, GIP, and insulin was due to the massive resection of the distal stomach, the upper small intestine, and the head of the pancreas and to the diversion of the stream of food from the duodenum to the jejunum. It is also assumed that the glucose-dependent insulinotropic action of GIP would be impaired by the procedure.

Effect of C-terminal fragments of glucagon on insulin secretion in dogs.

Although the insulinotropic action of glucagon is well known, which parts of the glucagon molecule play an important role in its action remain to be elucidated. To investigate the direct effect of the C-terminal peptides of glucagon on the endocrine function of the pancreas, glucagon (17-29), (21-29), (23-29), and (25-29) were studied using an in situ local circulation system of the canine pancreas. These glucagon fragments, as well as glucagon(1-29), were infused into the superior pancreaticoduodenal artery (PA) in a dosage of 400 pmol for 10 minutes during 0.5% glucose or 0.5% arginine infusion, and plasma insulin (IRI) and glucagon (IRG) levels in the superior pancreaticoduodenal vein (PV) were determined. During the glucose infusion, plasma IRI increased significantly following the administration of glucagon(23-29), (21-29), (17-29), or (1-29), but not glucagon(25-29). In these experiments, plasma IRG increased significantly following infusion of glucagon(21-29), (17-29), or (1-29). During the arginine infusion, all of the glucagon fragments studied enhanced insulin secretion, whereas plasma IRG was increased following the administration of glucagon(21-29), or (1-29). In these experiments with glucose or arginine infusion, blood glucose in the femoral artery (FA) did not change significantly except for glucagon(1-29), which increased the blood glucose level. In addition, the administration of graded doses of glucagon(21-29) [50, 150, and 400 pmol] during the glucose infusion elicited an increase in plasma IRI in a dose-related manner.(ABSTRACT TRUNCATED AT 250 WORDS)

Insulinotropic action of human glicentin in dogs.

Glicentin has been demonstrated to be released in response to the intraluminal administration of nutrients, but its biological action remains unknown. To clarify the effect of glicentin on the endocrine function of the pancreas, the present study was performed using an in vivo local circulation system of the canine pancreas. During infusion of 0.5% solution of glucose or arginine, 100 and 400 pmol glicentin and 400 pmol glucagon were administered into the pancreaticoduodenal artery (PA) within 10 minutes at 40-minute intervals successively. During glucose infusion, blood glucose in the femoral artery did not change following administration of 100 pmol glicentin, but slightly increased following 400 pmol glicentin. Plasma insulin (immunoreactive insulin [IRI]) in the pancreaticoduodenal vein (PV) increased significantly only following infusion of 400 pmol glicentin. Plasma glucagon (immunoreactive glucagon [IRG]), measured with a specific antiserum to the C-terminal portion of glucagon, did not change following administration of 100 pmol glicentin, but was slightly elevated following 400 pmol glicentin. Plasma total IRG, measured with a nonspecific antiserum, increased promptly after administration of 100 and 400 pmol glicentin. During arginine infusion, the response of plasma IRI to glicentin was markedly exaggerated both in dosages of 100 and 400 pmol. From the present study it was concluded that human glicentin clearly increases insulin release from the canine pancreas.

Hepatic steatosis and the elevated plasma insulin level in patients with endogenous hypertriglyceridemia.

Among 31 nonobese or obese patients with endogenous hypertriglyceridemia, hepatic steatosis was found by histologic examination of the biopsied specimen in 17 patients, and it was severe in six patients, They had no history of excessive alcohol intake. Chemical analysis revealed that the lipid accumulated in the liver was triglyceride. The hypertriglyceridemic patients, with or without histologic steatosis, showed significantly increased responses of both plasma insulin and blood glucose to oral glucose load compared with control subjects. The responses were more exaggerated in the hypertriglyceridemic patients with steatosis than in the hypertriglyceridemic patients without steatosis. Analysis of correlations between five variables (liver triglyceride, plasma insulin, blood glucose, body weight index, and serum triglyceride) was done on 15 subjects whose liver triglyceride values were quantified, and highly significant correlations were found between liver triglyceride and plasma insulin, blood glucose, or body weight index. A step wise multiple regression analysis performed on the five variables with liver triglyceride as the dependent variable revealed that the plasma insulin level was the most closely related variable, and the blood glucose level the next. The prediction equation for liver triglyceride as a function of plasma insulin and blood glucose levels (r = 0.91, p greater than 0.001) accounted for 84 percent of the total variance of liver triglyceride. It was shown that the decay of intravenously injected insulin in plasma was not delayed in the hypertriglyceridemic patients with steatosis, while the insulin sensitivity examined after intravenous insulin injection significantly decreased in the hypertriglyceridemic patients with or without steatosis, thus suggesting that the hyperinsulinemia in the hypertriglyceridemic patients was due to an increased insulin secretion associated with the decrease in the insulin sensitivity. Therefore, the elevated plasma insulin and blood glucose levels--or the insulin insensitivity by itself--might be the essential abnormalities in patients with endogenous hypertriglyceridemia, which, in extreme cases, might lead to massive triglyceride accumulation in the liver.

Response of gastric inhibitory polypeptide to fat ingestion in normal dogs.

Because of the differences in the data concerning the mechanism by which gastric inhibitory polypeptide (GIP) is secreted following fat ingestion, we were prompted to investigate the characteristics of the GIP response to the triacylglycerol components in normal dogs. Oral administration of glycerol (1 g/kg) slightly elevated the blood glucose levels but not the plasma GIP. Palmitate (1 g/kg) administration did not change the blood glucose whereas the plasma GIP was increased remarkably and remained elevated at 120 min. Oral administration of tricaprylin (2 g/kg) did not elicit any discernible changes in the blood glucose nor in the plasma GIP. Column chromatography of plasma obtained from a dog after palmitate ingestion revealed three GIP-immunoreactive peaks: one peak corresponding to the authentic GIP, one to the large molecular weight peak, and one to the small molecular weight peak. Similar results were obtained with the plasma collected after fat ingestion. From the present study, it would appear that hydrolysis of triacylglycerol plays an important role in GIP release from the intestine. Furthermore, it is concluded that the long chain fatty acids stimulate GIP release whereas the medium chain fatty acids do not.

Effect of endogenous gastric inhibitory polypeptide (GIP) on the removal of triacylglycerol in dogs.

In order to clarify the effect of endogenous gastric inhibitory polypeptide (GIP) upon lipid metabolism, the removal of intravenously administered triacylglycerol was investigated following an oral glucose or galactose load in dogs. After an overnight fast, the triacylglycerol emulsion was infused at a constant rate of 1 ml/min for 90 min, and glucose, galactose or tap water was orally administered at 30 min. Blood glucose increased after the glucose load but it did not change following the galactose load or water ingestion. Plasma insulin increased after the glucose load but did not change after galactose or tap water ingestion. Plasma glucagon did not show any discernible change in the three experimental groups. Plasma GIP increased following the glucose or galactose load to 4360 or 1653 pg/ml, respectively. Plasma triacylglycerol increased to the same levels at 30 min in the three experimental groups. The peak levels of plasma triacylglycerol and integrated plasma triacylglycerol for 150 min did not differ in the three groups. Moreover, there was no difference in the removal rate of plasma triacylglycerol following the withdrawal of the fat emulsion. It is concluded from the present study that endogenously released GIP does not elicit any effect upon triacylglycerol removal.

Response of gastric inhibitory polypeptide (GIP) to oral administration of nutrients in normal and pancreatectomized dogs.

In order to clarify the response of plasma gastric inhibitory polypeptide (GIP) to various nutrients and to investigate the relationship between the pancreas and GIP secretion, an experimental study was performed using normal and pancreatectomized dogs. Oral administration of glucose (2 g/kg) or butter (2 g/kg) resulted in an increase of plasma GIP in five normal dogs. In contrast, oral administration of arginine (1 g/kg) did not produce any discernible changes in plasma GIP in normal dogs. In a group of nine pancreatectomized dogs, the fasting level of plasma GIP did not differ from that of the control group. Furthermore, glucose ingestion in the pancreatectomized group resulted in the same pattern and the same degree of change in plasma GIP as it did in the normal controls. In contrast, plasma GIP did not change at all following fat loading in the pancreatectomized group. However, butter with pancreatic enzymes elicited a significant rise of plasma GIP in the pancreatectomized dogs. The present study indicates that plasma GIP increases following oral administration of glucose or fat but not arginine. Furthermore, it is demonstrated that GIP secretion following fat ingestion occurs only after fat digestion by pancreatic enzymes. In addition, the findings observed in the present study do not support the existence of feedback effect of insulin on GIP secretion.

Plasma glicentin in diabetic and gastrectomized patients.

Recent successful synthesis of human glicentin prompted us to establish an immunoassay method for determination of human glicentin in plasma. Human glicentin in plasma was measured using a newly developed sandwich ELISA. The mean fasting levels of human glicentin were 18.6+/-2.4 and 19.7+/-2.1 pM in normal subjects and diabetic patients, respectively. In diabetic patients with renal failure, plasma glicentin was elevated, exceeding 100 pM. In normal subjects, plasma glicentin increased to a peak level of about 130 pM at 60 min after an oral glucose load, and then decreased. In patients who underwent gastrectomy, plasma glicentin rapidly increased to a peak of about 300 pM at 30 min after oral glucose load. In a patient with short bowel syndrome plasma glicentin did not change following an oral glucose load. These results correspond with previous findings for gut glucagon-like immunoreactive materials (GLI) or enteroglucagon. We conclude that glicentin is secreted from the small intestine in response to intraluminal glucose stimulation in humans.

Secondary diabetic retinopathy in chronic pancreatitis.

We found abnormal glucose tolerance curves in 45 of 47 patients with chronic pancreatitis and observed secondary diabetic retinopathy in eight of 45 cases showing slight changes in the fundus. Abnormal glucose tolerance curves were somewhat related to the exocrine dysfunction of the pancreas. Slightly abnormal glucose tolerance curves were observed frequently in patients with chronic pancreatitis, and both insulin and glucagon responses were decreased. We could not explain the cause of the low frequency of secondary diabetic retinopathy in pancreatic diabetes from the results of insulin and glucagon response tests.

Response of plasma glicentin to intraduodenal administration of glucose in piglets.

Controversial results concerning the secretion of glicentin prompted us to investigate the response of circulating glicentin to intraduodenal administration of glucose in piglets. A 20% solution of glucose (2 g/kg) was administered into the duodenum of six piglets in a fully conscious state. As blood glucose rose, plasma insulin increased to a peak of 21 +/- 4 microU/ml. Plasma glucagon, determined by C-terminal-specific antiserum, was 70 +/- 30 pg/ml at fasting and slightly increased after the glucose load. Plasma immunoreactive glucagon measured by cross-reacting glucagon antiserum increased from the baseline of 1563 +/- 260 to a peak of 4738 +/- 415 pg/ml at 120 min. Plasma glicentin determined by antiserum R 64 was 463 +/- 81 pmol/l at baseline and reached a peak level of 1081 +/- 174 pmol/l at 90 min. The percent changes of plasma glucagon from the fasting level measured by cross-reacting antiserum and glicentin were 296 and 233%, respectively. There was a significant correlation between plasma glucagon measured by cross-reacting antiserum and glicentin (r = 0.817, P less than 0.001). Chromatography of plasma obtained during glucose load revealed the heterogeneity of glicentin. It can be concluded from the present study that glicentin is clearly secreted in response to intraluminal administration of glucose.

Response of plasma glicentin to fat ingestion in piglets.

In order to elucidate the response of plasma glicentin to fat ingestion, butter, glycerol or palmitate was administered into the duodenum of piglets in a fully conscious state and plasma glicentin and glucagon were determined. Butter instillation did not change blood glucose. Plasma triglyceride rose gradually 120 min after butter loading. Plasma insulin and glucagon measured by antiserum specific to the C-terminal slightly increased following butter administration and plasma total glucagon and glicentin increased gradually and significantly. The increments of total glucagon and glicentin were 179 and 158%, respectively. However, chromatography of porcine plasma obtained during fat loading revealed heterogeneity of glicentin-related peptides. Glycerol ingestion induced a slight rise of plasma total glucagon. Administration of palmitate revealed an increase in plasma total glucagon and glicentin. The present study clearly demonstrates the secretion of glicentin following fat ingestion, which might be caused by the hydrolysates of triglyceride, as suggested in previous dog experiments.