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G. Ribes, R. Gross, D. Chenon and M. M. Loubatières-Mariani

Abstract. The effect of insulin on basal pancreaticoduodenal output of SRIH was investigated in vivo and compared in normal and alloxan diabetic dogs. The experiments were performed on anesthetized dogs having a T-shaped catheter inserted into the pancreaticoduodenal vein just at the exit of the pancreas for blood sampling. In normal dogs, an insulin infusion (1 IU/kg for 20 min) or an iv insulin injection (0.2 IU/kg over 30 sec) produced, before any change in glycemia, an immediate reduction of the venous pancreaticoduodenal output of SRIH. Then pancreaticoduodenal output of SRIH rose close to starting values and decreased again when blood glucose level became very low. In alloxandiabetic dogs, insulin infusion (1 IU/kg for 20 min) also induced an immediate inhibitory effect on pancreaticoduodenal SRIH output; the effect was more transient and from 20 min, unlike in normal dogs, an increase in pancreaticoduodenal output of SRIH was observed. In conclusion, exogenous insulin induces an immediate reduction in pancreaticoduodenal SRIH secretion both in normal and diabetic dogs, independently of basal blood glucose level and before any change in glycemia. In contrast, the delayed effect is different: SRIH secretion is reduced in normal dogs, whereas it is enhanced in diabetic dogs.

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D Deville de Périère, R Puech, D Hillaire-Buys and G Ribes

Streptozotocin-induced diabetes is accompanied by an increase in insulin-like immunoreactivity concentration in rat submandibular salivary glands. In this study we have examined whether, in normal state, maturation is accompanied by changes in insulin-like immunoreactivity concentration of rat submandibular salivary glands. Insulin-like immunoreactivity concentrations of submandibular salivary glands were significantly higher in 11 months old rats compared with 3.5 months old control animals. A pertussis toxin pretreatment provoked an increase in insulin-like immunoreactivity, suggesting that a pertussis toxin sensitive G-protein is involved in the regulation of insulin-like immunoreactivity in the rat submandibular salivary glands.

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A. Zerbib, G. Ribes, R. Gross, R. Puech and M. M. Loubatières-Mariani

Abstract.

Insulin and pancreatic somatostatin secretions were studied after stimulation with an arginine infusion (5 mmol/1) in isolated perfused pancreata of adult streptozotocin-diabetic rats. In the presence of 2.8 mmol/l glucose, arginine clearly stimulated insulin and somatostatin secretions in diabetic rats, whereas it was ineffective in normal rats. Thus, not only the B-cells, but also the D-cells of the pancreas from streptozotocindiabetic rats are hypersensitive to arginine. The infusion of insulin (4 U/l) did not modify this hypersensitivity of the D-cells to arginine in pancreata of streptozotocindiabetic rats.

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K Blijdorp, L Khajeh, G M Ribbers, E M Sneekes, M H Heijenbrok-Kal, H J G van den Berg-Emons, A J van der Lely, F van Kooten and S J C M M Neggers

Objective

To determine the diagnostic value of a ghrelin test in the diagnosis of GH deficiency (GHD) shortly after aneurysmal subarachnoid hemorrhage (SAH).

Design

Prospective single-center observational cohort study.

Methods

A ghrelin test was assessed after the acute phase of SAH and a GH-releasing hormone (GHRH)–arginine test 6 months post SAH. Primary outcome was the diagnostic value of a ghrelin test compared with the GHRH–arginine test in the diagnosis of GHD. The secondary outcome was to assess the safety of the ghrelin test, including patients' comfort, adverse events, and idiosyncratic reactions.

Results

Forty-three survivors of SAH were included (15 males, 35%, mean age 56.6±11.7). Six out of 43 (14%) SAH survivors were diagnosed with GHD by GHRH–arginine test. In GHD subjects, median GH peak during ghrelin test was significantly lower than that of non-GHD subjects (5.4 vs 16.6, P=0.002). Receiver operating characteristics analysis showed an area under the curve of 0.869. A cutoff limit of a GH peak of 15 μg/l corresponded with a sensitivity of 100% and a false-positive rate of 40%. No adverse events or idiosyncratic reactions were observed in subjects undergoing a ghrelin test, except for one subject who reported flushing shortly after ghrelin infusion.

Conclusion

Owing to its convenience, validity, and safety, the ghrelin test might be a valuable GH provocative test, especially in the early phase of SAH.