title: Assessment of proinsulin's effects on intermediary metabolism using the forearm technique in normal man.
abstract: We have compared the effects of human proinsulin and insulin on forearm metabolism. Seven normal, non-obese subjects were infused with 386 pmol/kg per hour of proinsulin and 180 pmol/kg per hour of insulin using the euglycaemic clamp technique. Glucose appearance and utilization rates were quantified using a primed continuous infusion of [6',6'-2H2]glucose. Mean blood glucose was 4.1 +/- 0.1 and 4.1 +/- 0.2 mmol/l during proinsulin and insulin infusions respectively. Basal insulin concentrations increased from 0.02 +/- 0.01 to 0.25 +/- 0.03 nmol/l. The proinsulin infusion was chosen to give steady-state levels approximately 20-fold higher on a molar basis than those of insulin, based on previous findings that proinsulin has only 5% the biological potency of insulin. Basal proinsulin concentrations increased from 0.003 to 5.4 +/- 0.3 nmol/l. Hepatic glucose production was suppressed similarly during the last hour of each hormone infusion: 0.07 +/- 0.16 (proinsulin, P), and 0.01 +/- 0.13 (insulin, I) mg/kg per minute. Glucose disposal, however, was significantly increased during the final hour of the insulin infusion: 4.7 +/- 0.4 (I) and 3.4 +/- 0.2 (P) mg/kg per minute (P = 0.025). Net forearm glucose uptake (FGU) increased by a greater amount during insulin compared with proinsulin infusion: 1.44 +/- 0.02 (I) and 0.71 +/- 0.01 (P) mumol/100 ml forearm per minute (P < 0.02).(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: L
authors.initials: L
authors.lastname: Monti
authors.forename: P M
authors.initials: PM
authors.lastname: Piatti
authors.forename: M
authors.initials: M
authors.lastname: Ansiferov
authors.forename: C
authors.initials: C
authors.lastname: Hetherington
authors.forename: M
authors.initials: M
authors.lastname: Brown
authors.forename: H
authors.initials: H
authors.lastname: Orskov
authors.forename: W
authors.initials: W
authors.lastname: Branch
authors.forename: C N
authors.initials: CN
authors.lastname: Hales
authors.forename: K G
authors.initials: KG
authors.lastname: Alberti
mesh_terms: D000328:Adult; D000409:Alanine / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D003903:Deuterium; D005542:Forearm; D005947:Glucose / Q000378:metabolism*; D015309:Glucose Clamp Technique; D005990:Glycerol / Q000097:blood; D006801:Humans; D007328:Insulin / Q000494:pharmacology*; D007773:Lactates / Q000097:blood*; D008099:Liver / Q000187:drug effects / Q000378:metabolism; D008297:Male; D011384:Proinsulin / Q000494:pharmacology*; D011773:Pyruvates / Q000097:blood*; D011865:Radioisotope Dilution Technique; D012016:Reference Values
chemical_list: D001786:Blood Glucose; D007328:Insulin; D007773:Lactates; D011773:Pyruvates; D011384:Proinsulin; D003903:Deuterium; D005947:Glucose; D000409:Alanine; D005990:Glycerol