Glucagon processes on intestines in surgically stressed patients

Introduction

Although insulin/glucagon molar ratio (I/G) in serum is one of the most important factor to regulate the energy metabolic status of critically ill patients, the kinetics of I/G, especially glucagon, is still not well known. In this study, we investigated the I/G and the kinetics of glucagon related peptides and discuss the glucagon processes in pancreas and intestine in surgically stressed patients. Furthermore, we investigated the energy metabolic status and discuss the correlation between these results and the glucagon processes.

Subjects and methods

Sixteen patients with acute abdomen or trauma who had undergone emergency surgeries served as the subjects. At the 2nd and 7th days after surgeries, the following items were estimated. Serum I/G and glucagon related peptides were assessed using N-terminal and C-terminal specific RIA. Molecular forms of the glucagon related peptides were also estimated using gel filtration chromatography method. Furthermore the energy metabolic status were assessed using indirect calorimetry.

Results

On the 2nd days, 75% of patients showed lower I/Gs compared to those of normal subjects and the very peculiar peptides similar to the glicentin in molecular weights which were not seen in normal subjects and supposed to be produced by peculiar glucagon processes in intestines, were observed. Furthermore, in these patients, carbohydrates were well utilized as energy sources, while, in the residual 25% of patients who did not show the peculiar glicentin like peptides in chromatographies, carbohydrates were not sufficiently utilized, and lipid metabolism were increased.

Conclusion

The I/G and the processes of glucagon, especially in the intestine in surgically stressed patients were much different from those of normal subjects and must influence the energy metabolic status.