Responses to the Injection of Epinephrine in Hepatic Disease

Loeb, Robert F.; Reeves, Esther B.; Glasier, H. Pelham

doi:10.1172/jci100339

Cited by 18 publications

(4 citation statements)

References 10 publications

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“…The blood sugar findings corresponding to the fatty acid curves are not given in detail, but corresponded to those reported by Loeb, Reeves and Glasier (15). They seemed to show no constant changes consistent with the underlying hepatic condition.…”

Section: Resultssupporting

confidence: 72%

Plasma Fatty Acids After Adrenalin Injection in Normal Subjects and in Patients With Liver Disease: Prognostic Significance

Jones¹,

Fish²

1935

J. Clin. Invest.

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Section: Resultssupporting

confidence: 72%

Plasma Fatty Acids After Adrenalin Injection in Normal Subjects and in Patients With Liver Disease: Prognostic Significance

Jones¹,

Fish²

1935

J. Clin. Invest.

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“…16 Judging from the results of the glucagon loading test and the epinephrine loading test in our patient, hepatic glycogen was maintained. 19,20 Hepatic glycogenolysis depends upon the availability of stored glycogen. During a fast the breakdown of hepatic glycogen can provide glucose to the circulation in an adult for 24-48 h. This process is stimulated by glucagon secreted by the α-cells of the pancreatic islets and by catecholamines secreted by the enterochromaffin system.…”

Section: Discussionmentioning

confidence: 99%

Diabetic end-stage renal failure with autonomic dysfunction and spontaneous hypoglycemia during fasting

et al. 2000

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Spontaneous hypoglycemia during fasting was frequently observed in a 53-year old man with diabetic end-stage renal failure. On fasting, despite being managed on dietary therapy, this patient developed hypoglycemia (independent of hemodialysis), at which time he was lethargic. He showed severe autonomic dysfunction for a long period. No significant transient increase in catecholamines was not observed in response to the Schellong test or during the hypoglycemic episodes. During the oral glucose tolerance test (OGTT) and intravenous glucose tolerance test (IVGTT), basal insulin level was not detectable, and insulin response was absent. Glucagon loading test and epinephrine loading test suggested that the glycogen store in the liver was maintained, but that glycogenolysis was impaired. Lack of catecholamine response and diminished glucagon response to hypoglycemia because of autonomic disinnervation may suppress hepatic glycogenolysis and renal gluconeogenesis, thereby resulting in fasting hypoglycemia in pathologic situations such as diabetes mellitus and renal insufficiency.

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“…Brill and Fitz-Hugh (10) and Loeb, Reeves, and Glasier (11) reported that the hyperglycemic response to a standard dose of epinephrine in patients with hepatic disease is well below normal. However, injection of epinephrine has serious disadvantages as a means of estimating liver glycogen content.…”

mentioning

confidence: 99%

Glucagon-Induced Hyperglycemia as an Index of Liver Function 12

Itallie¹,

Bentley²

1955

J. Clin. Invest.

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Glucagon is a protein substance in pancreatic extracts which raises blood glucose by stimulating hepatic glycogenolysis (1-3). For this reason, it has been termed the hyperglycemic glycogenolytic factor (HGF) of the pancreas. Sutherland and Cori (2) have shown that glucagon increases the concentration of active phosphorylase in liver slice preparations. Apparently, glucagon administration does not induce glycogenolysis in muscle (4, 5).Whether glucagon has an effect on extrahepatic utilization of glucose is still a matter of controversy. Drury, Wick, and Sherrill (6) have reported that the rate of uptake of C'4-labeled glucose by eviscerated-nephrectomized rabbits actually decreases when glucagon is administered to such animals. On the other hand, Root, Ellis, and Staub (7), using intact rabbits and mice, have demonstrated that the presence of glucagon in insulin solutions in ratios of from 1: 100 to 1: 1 does not influence the degree of hypoglycemia produced by insulin and does not alter the potency of the insulin preparation as determined by the mouse convulsion assay. Ingle, Nezamis, and Humphrey (8) were unable to demonstrate any influence of glucagon upon extrahepatic glucose utilization in eviscerated rats. Using peripheral arteriovenous glucose differences as an index of peripheral glucose utilization in healthy human subjects, Van Itallie, Morgan, and Dotti (9) have found that glucagon does not inhibit and may accelerate uptake of glucose by peripheral tissues.It has been known for many years that the diseased liver usually does not contain a normal quantity of glycogen.

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Responses to the Injection of Epinephrine in Hepatic Disease

Cited by 18 publications

References 10 publications

Plasma Fatty Acids After Adrenalin Injection in Normal Subjects and in Patients With Liver Disease: Prognostic Significance

Plasma Fatty Acids After Adrenalin Injection in Normal Subjects and in Patients With Liver Disease: Prognostic Significance

Diabetic end-stage renal failure with autonomic dysfunction and spontaneous hypoglycemia during fasting

Glucagon-Induced Hyperglycemia as an Index of Liver Function 12

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