title: Autoantibodies to the insulin receptor impair clearance of plasma endogenous insulin.
abstract: Plasma insulin clearance was studied in a patient with autoantibodies to the insulin receptor, manifesting persistent hyperinsulinemia associated with alternating hyper- and hypoglycemia. In the postabsorptive period, the plasma glucose level gradually decreased. To prevent the development of hypoglycemia, glucose was infused and the glycemic level was clamped at 50 mg/dl without insulin infusion. The plasma C-peptide level was below the detectable range during the clamp, indicating no appreciable secretion of insulin. The plasma insulin level declined exponentially with a markedly prolonged disappearance rate (half-time: 3.0 h) during the study. These results indicate that hyperinsulinemia in the postabsorptive period in this patient is attributable to the impairment of plasma insulin clearance through receptor-mediated mechanisms, and also confirm that the receptor plays the principal role in plasma insulin removal.
authors.affiliation: Second Department of Internal Medicine, Osaka University Medical School, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kiyokawa
authors.forename: N
authors.initials: N
authors.lastname: Kono
authors.forename: T
authors.initials: T
authors.lastname: Hamaguchi
authors.forename: M
authors.initials: M
authors.lastname: Kawachi
authors.forename: K
authors.initials: K
authors.lastname: Tajima
authors.forename: Y
authors.initials: Y
authors.lastname: Yamada
authors.forename: N
authors.initials: N
authors.lastname: Hara
authors.forename: I
authors.initials: I
authors.lastname: Mineo
authors.forename: M
authors.initials: M
authors.lastname: Kuwajima
authors.forename: S
authors.initials: S
authors.lastname: Tarui
mesh_terms: D000052:Acanthosis Nigricans / Q000097:blood / Q000276:immunology*; D001323:Autoantibodies; D001786:Blood Glucose / Q000378:metabolism; D015309:Glucose Clamp Technique; D006801:Humans; D007328:Insulin / Q000097:blood*; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D011972:Receptor, Insulin / Q000276:immunology* / Q000378:metabolism
chemical_list: D001323:Autoantibodies; D001786:Blood Glucose; D007328:Insulin; D011972:Receptor, Insulin