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1 Division of Endocrinology, Department of Internal Medicine, Kanazawa Medical University, Uchinada 920-0293; 2 Department of Internal Medicine, Shinminato Municipal Hospital, Shinminato 934-0053; and Department of Internal Medicine (II), School of Medicine, Kanazawa 920-8641; and 3 Division of Life Science, Graduate School of Natural Science and Technology and Health Science Service Center, Kanazawa University, Kanazawa 920-1192, Japan
To determine whether the appearance of
nutrients into the gastric lumen per se provokes insulin secretion,
glucose solution was instilled into the pylorus-cannulated stomach via
an orogastric tube in anesthetized dogs. When 200 ml of 0, 5, 10, and
20% glucose solution were sequentially instilled, transgastric
gradients (TGG) of plasma glucose concentration across the fundus
[short gastric vein (SGV)
femoral artery, TGG(SGV)] and
insulin levels in the superior pancreaticoduodenal vein (SPDV)
increased stepwise. Upon instillation of 300 ml of 10% glucose, but
not 1.8% saline, for 12 min followed by 48-min spontaneous drainage
via the cannula (n = 5 each), TGG(SGV) and insulin
levels in the SPDV increased concomitantly and significantly by 0.95 mM
and 1,334 pM (mean), respectively, regardless of unaltered arterial
glucose levels. The amount of secreted insulin (area under the curve)
significantly correlated with the maximum TGG(SGV) (r = 0.693). In selectively gastric-vagotomized dogs (n = 5), insulin levels in the SPDV did not increase upon instillation
despite a TGG(SGV) rise comparable to that in normal dogs. These
results indicate that intragastric glucose appearance provokes
vagus-mediated insulin secretion probably related to the transfundic
glucose flux, suggesting the presence of a novel neurogenic
gastroinsular axis.
intragastric glucose instillation; short gastric vein; insulin secretion; gastric vagotomy
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