title: The effects of human proinsulin on glucose turnover and intermediary metabolism.
abstract: We compared the effects of human proinsulin and human insulin on glucose disposal, suppression of hepatic glucose production (HGP), and intermediary carbohydrate and lipid metabolism. Six young, lean, subjects underwent eight separate euglycemic clamps with low-dose intravenous (IV) infusions of insulin and proinsulin (four each). The insulin infusions gave steady-state levels of 0.08 +/- 0.004 (I1), 0.12 +/- 0.003 (I2), 0.18 +/- 0.07 (I3), and 0.25 +/- 0.06 nmol/L (I4). The proinsulin infusions were chosen to give steady-state levels approximately 20-fold higher on a molar basis than insulin, based on previous findings that proinsulin has only 5% to 10% the biological potency of insulin. Steady-state proinsulin levels were 1.2 +/- 0.04 (P1), 2.8 +/- 0.07 (P2), 4.5 +/- 0.3 (P3), and 6.9 +/- 0.3 nmol/L (P4). HGP was suppressed equally by proinsulin and insulin at the four dose levels. Percentage elevation of glucose disposal was significantly increased during each of the insulin infusions compared with proinsulin: I1 107% +/- 4%, P1 87% +/- 4% (P = .03); I2 143% +/- 7%, P2 125% +/- 12% (P = .01); I3 238% +/- 38%, P3 173% +/- 22% (P = .03); I4 283% +/- 17%, P4 178% +/- 11% (P = .002). Dose-response curve analysis demonstrated that proinsulin stimulated glucose disposal approximately 3.3% compared with insulin. The effectiveness of proinsulin in suppressing HGP was approximately 5% compared with insulin. Plasma nonesterified fatty acids, blood glycerol, and 3-hydroxybutyrate were suppressed by similar amounts during each of the four insulin and proinsulin doses.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Medicine, Medical School, Newcastle upon Tyne, UK.
authors.forename: S N
authors.initials: SN
authors.lastname: Davis
authors.forename: P C
authors.initials: PC
authors.lastname: Butler
authors.forename: M
authors.initials: M
authors.lastname: Brown
authors.forename: S
authors.initials: S
authors.lastname: Beer
authors.forename: W
authors.initials: W
authors.lastname: Sobey
authors.forename: I
authors.initials: I
authors.lastname: Hanning
authors.forename: P D
authors.initials: PD
authors.lastname: Home
authors.forename: C N
authors.initials: CN
authors.lastname: Hales
authors.forename: K G
authors.initials: KG
authors.lastname: Alberti
mesh_terms: D000328:Adult; D050260:Carbohydrate Metabolism; D005947:Glucose / Q000096:biosynthesis / Q000378:metabolism; D015309:Glucose Clamp Technique; D006801:Humans; D007275:Injections, Intravenous; D007328:Insulin / Q000378:metabolism; D050356:Lipid Metabolism; D008099:Liver / Q000378:metabolism; D008297:Male; D008657:Metabolic Clearance Rate; D011384:Proinsulin / Q000378:metabolism*; D012016:Reference Values
chemical_list: D007328:Insulin; D011384:Proinsulin; D005947:Glucose