The effect of systemic venous drainage of the pancreas on insulin sensitivity in dogs.
Open Access
- 1 October 1993
- journal article
- Published by American Society for Clinical Investigation in JCI Insight
- Vol. 92 (4), 1713-1721
- https://doi.org/10.1172/jci116758
Abstract
To assess the metabolic consequences of the diversion of the pancreatic venous drainage to the systemic circulation, the pancreaticoduodenal and gastrosplenic veins were anastomosed to the inferior vena cava in nine normal dogs. This procedure maintained the integrity of the entire pancreas while shunting the hormonal output of the pancreas to the periphery. The metabolic effects were assessed from the sensitivity to insulin during a euglycemic hyperinsulinemic glucose clamp using an insulin infusion of 800 microU/kg per min. The studies were controlled by their duplication in seven dogs identically treated but with the pancreatic veins reanastomosed to the portal vein. No differences in systemic insulin levels or insulin sensitivity before and after surgery were seen under these circumstances. After diversion, however, basal insulin levels rose from 4.5 +/- 1.0 to 11.5 +/- 2.5 microU/ml. Basal glucose metabolic clearance rate (MCR) rose to 3.0 +/- 0.4 from 2.0 +/- 0.3 ml/kg per min. On insulin infusion, maximal stimulation of MCR within the 2-h infusion period was to 15.2 +/- 2.5 ml/kg per min preoperatively and to 7.2 +/- 0.8 ml/kg per min after diversion. Using ratios of MCR-to-insulin concentration as an index of insulin sensitivity, it was demonstrated that this index decreased by at least 50% after diversion. These data imply that portal venous drainage of the pancreas is an important factor in the determination of peripheral insulin sensitivity.Keywords
This publication has 42 references indexed in Scilit:
- Pancreas Transplantation An Initial Experience With Systemic and Portal Drainage of Pancreatic AllograftsAnnals of Surgery, 1992
- Consequences of systemic venous drainage and denervation of heterotopic pancreatic transplants for insulin/C-peptide profiles in the basal state and after oral glucoseDiabetologia, 1991
- Relationship between insulin sensitivity, insulin secretion and glucose tolerance in cirrhosisHepatology, 1991
- Effects of Hemipancreatectomy on Insulin Secretion and Glucose Tolerance in Healthy HumansNew England Journal of Medicine, 1990
- Glucose and insulin metabolism in cirrhosisJournal of Hepatology, 1989
- Physiologic evaluation of factors controlling glucose tolerance in man: measurement of insulin sensitivity and beta-cell glucose sensitivity from the response to intravenous glucose.JCI Insight, 1981
- Comparison of the metabolic responses to portal and peripheral infusions of insulin in diabetic dogsMetabolism, 1981
- Effects of portacaval anastomosis on glucose tolerance in the dog: Evidence of an interaction between the gut and the liver in oral glucose disposalMetabolism, 1975
- A Model of the Kinetics of Insulin in ManJCI Insight, 1974
- Measuring Rates of Appearance in Systems Which are not in Steady StateCanadian Journal of Physiology and Pharmacology, 1973