Exaggerated response of plasma glucagon-like immunoreactivity (GLI) to oral glucose in patients with reactive hypoglycemia.

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  • SHIMA KENJI
    Department of Medicine and Geriatrics, Osaka University Medical School
  • TABATA MASAKO
    Department of Medicine and Geriatrics, Osaka University Medical School
  • TANAKA AKIRA
    Department of Medicine and Geriatrics, Osaka University Medical School
  • KODAIRA TSUKASA
    Resaerch and Development Division, Ostuka Assay Laboratories, Otsuka Pharmaceutical Co., Ltd.
  • NISHINO TOMOYOSHI
    Resaerch and Development Division, Ostuka Assay Laboratories, Otsuka Pharmaceutical Co., Ltd.
  • KUMAHARA YUICHI
    Department of Medicine and Geriatrics, Osaka University Medical School

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タイトル別名
  • Exaggerated Response of Plasma Glucagon

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In order to study the pathogenesis of reactive hypoglycemia, the responses of plasma glucose, IRI, glucagon immunoreactivity (GI) and total glucagon-like immu-noreactivity (GLI) to 100g oral glucose load were investigated in twenty-six patients of normal weight with reactive hypoglycemia. Of these patients, nineteen exhibited a diabetic OGTT curve. The findings in these patients were compared to normal control subjects (N=20) and to disease-matched patients controls (N=43). The psy- chological status was assessed by Cornell Medical Index Health Questionnaire in most of the subjects, who also received an x ray examination of the upper gastrointestinal tract. In addition, IVGTT was performed in the hypoglycemic patiens. No apparent difference in plasma IRI response to oral glucose was observed between the hypo-glycemic patients and their respective controls. Plasma total GLI concentrations were significantly increased during OGTT in both hypoglycemic groups. Following an oral glucose load, plasma GI levels were suppressed in the hypoglycemic groups to an extent similar to that in the control despite an apparent fall in their plasma glucose levels to the hypoglycemic range in the former. Radiological alterations in the upper gastrointestinal tract; deformity of the duodenal cap, gastric and/or duodenal ulcer, were found more frequently in the hypoglycemic groups. However, no characteristic change in personality was noticed in the patients. During IVGTT, neither plasma glucose nor total GLI level of the hypoglycemics differed from that of each control. The pathogenic factors responsible for reactive hypoglycemia will be discussed.

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