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 level...

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Bibliographic Details
Published in:American journal of physiology: endocrinology and metabolism 2001-01, Vol.280 (1), p.E50-E58
Main Authors: Hojlund, K, Wildner-Christensen, M, Eshøj, O, Skjaerbaek, C, Holst, J J, Koldkjaer, O, Møller Jensen, D, Beck-Nielsen, H
Format: Article
Language:English
Subjects:
Adult
Aged
B-Lymphocytes - chemistry
Blood Glucose
Body Mass Index
C-Peptide - blood
Chemistry, Clinical - standards
Epinephrine - blood
Fasting - physiology
Fatty Acids, Nonesterified - blood
Female
Glucagon - blood
Human Growth Hormone - blood
Humans
Hydrocortisone - blood
Hyperinsulinism - blood
Hyperinsulinism - diagnosis
Hypoglycemia - blood
Hypoglycemia - diagnosis
Insulin - blood
Male
Middle Aged
Norepinephrine - blood
Peptides - analysis
Proinsulin - blood
Reference Values
Serum Albumin
Sex Factors
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Summary: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.
ISSN:0193-1849
1522-1555
DOI:10.1152/ajpendo.2001.280.1.e50