Reference intervals for glucose, beta-cell polypeptides, and counterregulatory factors during prolonged fasting.
To establish reference intervals for the pancreatic beta-cell response and the counterregulatory hormone response to prolonged fasting, we studied 33 healthy subjects (16 males, 17 females) during a 72-h fast. Glucose, insulin, C-peptide, and proinsulin levels decreased (P < 0.001), and the levels of counterregulatory factors increased during the fast [P < 0.05; glucagon and free fatty acids (FFA) with a linear increase and epinephrine, norepinephrine, and cortisol with a clear underlying circadian rhythm]. Growth hormone secretion increased from the first to third day of fasting (P < 0.05) but actually decreased from the second to third day of fasting (P = 0.03). Males had higher glucose and glucagon levels and lower FFA levels during the fast (P < 0.05), whereas no effect of gender on beta-cell polypeptides was observed. A high body mass index resulted in higher insulin and C-peptide levels during the fast (P < 0.05). In conclusion, we have provided reference intervals for glucoregulatory factors during a 72-h fast. We observed a diminished beta-cell response concomitant with an increased secretion of counterregulatory hormones. These results should be of clinical and scientific value in the investigation of hypoglycemic disorders.
Hojlund
K
K
Diabetes Centre, Department of Endocrinology, Odense University Hospital, DK-5000 Odense C, Denmark. k.hojlund@dadlnet.dk
Wildner-Christensen
M
M
Eshøj
O
O
Skjaerbaek
C
C
Holst
J J
JJ
Koldkjaer
O
O
Møller Jensen
D
D
Beck-Nielsen
H
H
D000328:Adult; D000368:Aged; D001402:B-Lymphocytes / Q000737:chemistry*; D001786:Blood Glucose; D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood; D002624:Chemistry, Clinical / Q000592:standards*; D004837:Epinephrine / Q000097:blood; D005215:Fasting / Q000502:physiology*; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005934:Glucagon / Q000097:blood; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006946:Hyperinsulinism / Q000097:blood / Q000175:diagnosis; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D010455:Peptides / Q000032:analysis*; D011384:Proinsulin / Q000097:blood; D012016:Reference Values; D012709:Serum Albumin; D012737:Sex Factors
D001786:Blood Glucose; D002096:C-Peptide; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D010455:Peptides; D012709:Serum Albumin; D019382:Human Growth Hormone; D005934:Glucagon; D011384:Proinsulin; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine